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1 <br /> COOLER RECEIPT FORM <br /> Sect �o �.L"C4'� Q 1-09 - Log No ��-- <br />' �0 <br /> 1er receive on a nd checked on by <br /> (signature) <br />' re custody papers present-" NO <br /> re custody capers Groper ly fitted out' �-3 NO <br />� yre the custody papers signed' �YE NO <br /> is sufficient ice used' C9 NO <br />� Ld all bottles arrive in good condition (unbroken) E NO <br /> Ld bottle labels match COC' ' ��) NO <br /> Iere proper bottles used for analysis indicated '�YE .) NO <br /> -,rrect preservatives used' YEj NO <br /> rDA vials checked for headspace bubbles '`�� YES NO <br /> Note which voas ( if any) had bubbles <br /> ample descriptor Number of vials <br /> X11 VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis YES NO <br />, ist here all other fobs received in the same cooler <br /> '1 lent Job # NET log <br /> r <br /> (coolerrec) <br />