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COOLER RECEIPT CHECKLIST Curtis&Tompkins,Ltd. <br /> cb <br /> Login# �Z +`" I Date Received $I Number of coolers I <br /> ClientC.� Project tNOr� tTt�n'a1 S � <br /> Date Opened 4t1 By(print) (sign) --- <br /> Date Logged in By(print) (sign) <br /> 1.Did cooler come with a shipping slip (airbill, etc) YES <br /> Shipping info <br /> 2A. Were custody seals present? ._. ❑YES (circle) on cooler on samples )!S%O <br /> How many Name Date <br /> 2B. Were custody seals intact upon arrival? YES NO <br /> 3. Were custody papers dry and intact when received? CM NO <br /> 4. Were custody papers filled out properly(ink, signed, etc)? NO <br /> 5. Is the project identifiable from custody papers? (If so fill out top of form) S NO <br /> 6. Indicate the packing in cooler: (if other,describe) <br /> ❑Bubble Wrap ❑Foam blocks , Oags ❑None <br /> ❑Cloth material ❑Cardboard ❑Styrofoam ❑Paper towels <br /> 7. Temperature documentation: <br /> Type of ice used: )0 Wet ❑Blue/Gel ❑None Temp(OC) <br /> ❑ Samples Received on ice&cold without a temperature blank <br /> ❑ Samples received on ice directly from the field. Cooling process had begun <br /> 8. Were Method 5035 sampling containers present? jj )NO <br /> If YES,what time were they transferred to freezer? 1,3:10 <br /> 9.Did all bottles arrive unbroken/unopened? YES NO <br /> 10. Are samples in the appropriate containers for indicated tests? YES NO <br /> 11. Are sample labels present, in good condition and complete? YES NO <br /> ' 12. Do the sample labels agree with custody papers? YES NO <br /> 13. Was sufficient amount of sample sent for tests requested? YES NO <br /> 14. Are the samples appropriately preserved? YES NO <br /> ' 15.Are bubbles>6mm absent in VOA samples? YES NO <br /> 16. Was the client contacted concerning this sample delivery? YES NO <br /> If YES,Who was called? By Date: <br /> ' COMMENTS <br /> 1\0 laws P;I^cst'4 u" mr j . cAia* Ip WOW OngA1yV\.t pr SItWP�- <br /> ' <br /> rozu ool 2. mo-es JW am aAA It . <br /> SOP Volume: Client Services Rev.6 Number 1 of 3 <br /> ' Section: 1.1.2 Effective:23 July 2008 <br /> Page: 1 of 1 Z:\gc\fomu\checklists\Cooler Receipt Checklist rv6.doc <br /> 5 of 47 <br />