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COOLER RECEIPT FORM <br /> 91er <br /> ect X14\\\�-\2 Log No received on and checked on by <br /> ( signature) <br /> to custody papers present' YE NO <br /> re custody papers properly fi1yea oit ' � E NO <br /> ,re the custody papers signed' YES NO <br /> is suf Eicient ice used' NO � 1 <br /> s <br /> _d all bottles arrive in good condition (unbroken) -IES-) NO r r <br /> d bottle labels match COC' Y_F�S NO <br /> ire proper bottles used for analysis indicated' NO <br /> �1 <br /> Drrect preservatives used' YESJ NO <br /> �A vials checked for headspace bubbles' YES JNO <br /> Note which voas ( iE any) had bubbles * -' <br /> ample descriptor Number of vials <br /> all VOAs with headspace bubbles have been set aside so they will not be <br /> ased for analysis YES NO <br /> ist here all other )obs received in the same cooler <br /> Tient Job # NET log # <br /> (coolerrec) <br />