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SAMPLE RECEIPT CLIENT: _ C& OEC ID#: IW 2-��� Temp: ° C <br /> ae�avisnn Acceptable Range: OOC to 6°C <br /> COC RECEIVED RECEIPT LOGIN <br /> DATE/TIME: f /�C? /��"L •2 DATE/TIME: 06/68//Z 10 5" _ REFRIGERATOR(s): <br /> SAMPLE TRANSPORT,RECEIPT,CONDITION&PRESERVATION: Yes No N/A (*)PROBLEM CHAIN FORM NEEDED <br /> ❑OEC Courier/Sampler COC document(s)received with samples ® ❑* ❑ Custody Seals(circle): Present/ sent <br /> t'Delivery(Other than OEC Courier) Correct containers for analysis requested Co ❑* ❑ Samples/Coolers <br /> ❑Samples Received on Ice . Container(s)intact and in good condition W ❑* ❑ Intact/Broken* <br /> ❑Samples Received Outside Temp.Range* Container label(s)consistent with COC ❑* ❑ Method of Shipment&'Tracking#(ifapplicable). <br /> ❑Samples Direct from field(Outside Temp) OEC preservative added (**note std ID) ❑** ❑ <br /> ❑After-Hours Outside Drop-off[Brought Inside] Proper preservation on sample label(s) ❑ ❑ R (**}OEC Preservative ID: <br /> (Initials/Date/Time): VOA containers free of headspace ❑ ❑* ® Dissolved Metals Filtration:matenn tn'rexrve tnt <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 Date/Time Comments/Remarks I <br /> / H Sampled*** Condition Notes Etc. <br /> or <br /> RECEIPT LOGIN BY: / d '�" RECEIPT REVIEWED BY: Page of <br />