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SAMPLE RECEIPT CLIENT: OEC ID#: t s'.Q�-�' — Temp: "' °C <br /> Rev.1)1n5n0 Acceptable Range: 0°C to 6°C <br /> COC RECEIVED RECEIPT LOGIN <br /> DATE/TIME: ,5< DATE/TIME: Ste— 1 Z. 1 s. REFRIGERATOR(s): V <br /> SAMPLE TRANSPORT,RECEIPT,CONDITION&PRESERVATION: Yes No N/A (*)PROBLEM CHAIN FOR ]en <br /> ❑OEC Courier/Sampler COC document(s)received with samples ❑* ❑ Custody Scals.(circle): Present bs <br /> �elivery(Other than OEC Courier) Correct containers for analysis requested ❑* ❑ Samples/Coolers, <br /> ❑Samples Received on ice Container(s)intact and in good condition ❑* ❑ Intact/Brok <br /> ❑Samples Received Outside Temp..Range* Container label(s)consistent with COC ❑ � ❑ Method of Sh'pment&Tracking 11of np <br /> ❑Samples Direct from field(Outside Temp) OBC preservative added (**note std ID) Cl** ❑ Fed /2'a►/7� /p$�9 <br /> ❑After-Hours Outside Drop-off[Brought Inside] Proper preservation on sample label(s) ❑ ❑ � {*�)OEC Preservative ID: p S0 M <br /> (Initials/Dat ePl ime): VOA containers free of headspace ❑ ❑" � Dissolved Metals Filtration:matellnitll'res <br /> Tedlar Bas free of condensation ❑ ❑* <br /> CONTAINERS,COC CHANGES AND/OR CORRECTIONS CHANGES AUTHORIZED BY: <br /> OEC ID Client ID***If blank,refer to CoC Container Description Preservative ResCl Matrix Daterrime Comments/Remarks/ <br /> / H Sampled*** Condition Notes Etc. <br /> 60ttLe Vc-C 04r <br /> ewd t o w <br /> RECEIPT LOGIN BY: RECEIPT REVIEWED BY: Page or <br />