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COOLER RECEIPT FORM <br /> ]ect: Gj `act-Z1 Log No <br /> oler receive on: S-Vit, ana checked on 5- - b <br /> sign <br />.dere custody papers present' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ES NO <br /> dere custody papers properly filled out? . . . . . . . . . . . . . . . . E NO <br /> Gere the custody papers signed7 . . . . . . . . . . . . . . . . . . . . . . . . . CE) NO <br /> das sufficient ice used" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO <br /> Did all bottles arrive in good condition (unbroken) ",' . . . . . . . NO <br /> NO <br /> Did bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E NO <br /> dere proper bottles used for analysis indicated" . . . . . . . . . . . E NO <br /> 1orrect preservatives used-> . . . . . . . . . . . . . . . . . . . . . . . . . .E NO <br /> JOA vials checked for headspace bubbles' . . . . . . . . . . . . . NO <br /> Note which vows ( if any) had bubbles : * <br /> Sampl descriptor: Number of vials <br /> QL rQ 3 <br /> �- 5 call <br /> - � <br /> qW V6 .2 a <br />*All VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO <br /> moist here all other fobs received in the same cooler: <br /> Tient Job # NET log # <br /> I <br /> (coolerrec) <br />