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DCT-24-2M2 12=44 CALSCIENCE 714 894 7501 P.06/07 <br /> R <br /> %10 <br /> aiewf�* <br /> Yv1f�T�III##Al <br /> e�earet ee. WORK ORDER,##: 0240 0 - F1 51 <br /> Cooler of <br /> SAMPLE RECEIPT FORM <br /> CLIENT: L - - -- --- -- - DATE 0 Gt & - <br /> TEMPERATURE— SAMPLES RECEIVED BY: <br /> CALWIENCE COURIER: LABORATORY(Other than Calsdance Courier): <br /> Chilled. cooler wi"rnperature blank provoscl OC Temperature blank <br /> �,. _.. Chilled, cooler without tempefatur+a blank .�_ °C IR thermom$ter. <br /> Chilled and placed In cooler with wet fee. Ambient tempamture, <br /> AMbient and pieced in coalerwith wet Ice. <br /> - ...,.. Ambient tempemtum <br /> °C Temperature blank. initial: <br /> CU$TQDY SEAL INTACT: <br /> Sample )�,._..,.� Conley �,,� ..�►�r., a,aAppgad*(i+H <br /> Inulol, <br /> SAMPLE CONDITION: <br /> Cha r)-W cuswdy documents}rev eared with samplas,_, .,., Y" <br /> :. ... No NIA <br /> Sample container label(g)consistent vgth antody paper ^..... <br /> Sample contalner(s)Matt aW good condition ...., ......., .. ... �-... — <br /> QxTect containers for anatyses requested.. ., . ... .� •. <br /> proper preservation noted on sample label(s) .. .... . .—� <br /> V0AVial(s)f<9e0fgeed$ <br /> paCe .. .. . . .............. .. <br /> Tedsar ba -�..... <br /> 9(a)fire--of condensation _, . . .. <br /> lhittal. <br /> QQMMENTS: <br />