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--- -- _ -- <br /> ASSOCIATED L BORATOMES <br /> 846 North Batavia-Orange, California 92868-1225- 7,14/771-690o FAX 7141538--1209 <br /> Cooler Receipt Form <br /> Client: t l" f Project. Q, W <br /> Date Cooler Received: A� j Date Cooler Opened. <br /> Was cooler scanned for presence ofradioactivity ? Ye o� <br /> If yes was radioactivity results above 25 cpm ? Y o <br /> Was a shipper's packing slip attached to the cooler? cy:ioNo <br /> If the cooler had custody seal(s),were thy signed and intact? w/No/Na <br /> Was the cooler packed with: lee Ice Packs Bubble wrap <br /> Styrofoam Paper None Other <br /> Cooler Temperature• t U <br /> *cooler needs to be received @a 4°C with an acceptable range of 2°-6 °C <br /> If samples were hand delivered do they meet the temp criteria, which should be @ 4°C with <br /> an acceptable range of 2°- 6 °C? Yes/No <br /> If no explain- <br /> Were all samples sealed in plastic bags I Y s/No <br /> Did all samples arrive intact?If no,indicate below. �Ye-�To <br /> Were all samples labeled correctly ?(ID's Dates,Tunes)If no,indicate below. �§iNo <br /> Can the tests required be ran with the provided containers,If no indicate below. &es/No <br /> Was sufficient sample volume sent for all contamers ? tINO <br /> Were any VOA vials received with head space? Yes/�O/Na <br /> Was the correct preservatives used ? Yes/NW <br /> If no, see the pH log for a list of samples containers regarding pH <br /> Any other important information- <br /> i <br /> Re:cluing Department- 'r t Date: <br />