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A <br /> COOLER RECEIPT FORM <br />:)r�ct: �l� �Zti og No: �, <br /> c r receive on: an checked on b <br /> \ igna ure <br />+sere custody papers present? . . . . . . . . . . . . . . . . . . . . . . . . : £1' NO <br /> Were custody papers properly filled outer . . . . . . . . . . . . . . . . . . YE NO <br /> Were the custody papers signed . . . . . . . . . . . . . . . . . . . . . . . . .mss NO <br /> Was sufficient ice used? . . . . .-Y-ES NO `ELVR <br /> Did all bottles arrive in good condition (unbroken) ? . . . . . . . YZ& NO <br /> Did bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Y-Es NO <br /> Were proper bottles used for analysis indicated? . . . . . . . . . .X-S& NO i <br /> Correct preservatives used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 't 's NO <br /> VOA vials checked for headspace bubbles? . . . . . . . . . . . . . . . . . .SFS NO <br /> Note which voas ( if any) had bubbles: * <br /> Sample descriptor- Number of vials: <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br /> usedfor analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .YES NO <br /> List here all other fobs received in the same cooler: <br /> Client Jab # __ NET _lo <br /> Fyan <br /> Pe Com! Co <br /> (coolerrec) <br />