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1 <br /> COOLER RECEIPT FORM <br /> o3ect: Log No: Oto& <br />' ooler receive on: in c 0 and- checked on tZ -JDY7 <br /> signal <br />'Vere custody papers present' . . YE NO <br /> Jere custody papers properly filled out' YES NO <br />' .dere the custody papers signed' . . . . . . AYE v NO <br /> .Vas sufficient ice used' . . . E NO <br />'Did all bottles arrive in good condition (unbroken) ' YEJ NO n 2 � <br /> Did bottle labels match COC' . . . . . . . . . . . . uYES NO ` <br />'Were proper bottles used for analysis indicated' . . '. YE NO J <br /> Correct preservatives used' . . YES,) NO <br />'JOA vials checked for headspace bubbles' . . EY S NO <br /> Note which/ voas ( if any) had oubbles <br />'Sample descriptor Number of vials <br /> 1 <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br />' used for analysis . . YES NO <br /> List here all other )obs received in the same cooler: <br />'Client Job NET log # <br /> 1 <br /> (coolerrec) <br />