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4AI <br /> COOLER RECEIPT FORM <br /> rect :iLL. S G�✓ � `�/ /l-L�Log No l9Sa <br /> cooler receiv on -� r-yy a� c ec ed on _ by <br /> na ure <br /> {ere custody papers present' YE5 NO <br /> .ere custody papers properly fillea out" .'Y�ES NO <br /> +ere the custody papers signed' YES NO <br /> �as sufficient ice used' YES NO 17 P <br /> Did all bottles arrive in good conaztion (unbroken) ' _YDS' NO <br /> r� <br /> -)id bottle labels match COC' NO <br /> ,Pere proper bottles used for analysis indicated' NO <br /> �orrect preservatives used' EE NO <br /> ' OA vials cnecked for heaaspace bucoles' YES NO <br /> Note which voas ( if any) has bubbles <br /> Sample descriptor Nu-ner of vials <br /> r <br /> i <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 _n the same cooler- <br /> Client Job F NET log #� <br /> (coolerrec) <br />