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COOLER RECEIPT FORM <br /> 06ject: Log No: <br /> Cooler receive on: and checked on by <br /> (signature) <br /> dere custody papers present' . . . . . . . . . . . . . . . YE NO <br /> Were custody papers properly filled out' . . . . . . . . . . . . . YE NO <br /> Mere the custody papers signed-- . . . . . . . . . YE NO <br /> Was sufficient ice used' . . . . . . . . . . . . . . . YES NO 41 <br /> Did all bottles arrive in good condition (unbroken) ' . . . . . NO <br /> Did bottle labels match COC' . . . . . . . . . . . . . . . . . . . . . . . . YF NO <br /> were proper bottles used for analysis indicated? . . . . . . . �YF NO <br /> Correct preservatives used? . . . . . . . . . . . . . . . .(1!0 NO <br /> VOA vials checked for headspace bubbles' . . Y�F NO <br /> Note which voas ( if any) had bubbles : * <br /> Sample descriptor- Nuanber of vials <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 /> i (coolerrec) <br />