Laserfiche WebLink
TestAmerica <br /> THE LEADER IN ENVIRONMENTAL TESTING <br /> Nashville,TN COOLER RECI <br /> Cooler Received/Opened On 12/9/201 0800 NVL1479 <br /> 1. Tracking (last 4 digits,FedEx) <br /> Courier: FedEx IR Gun ID 94660220 <br /> 2. Temperature of rep.sample or temp blank when opened: ,6 Degrees Celsius <br /> 3. if Item#2 temperature is 0°C or less,was the representative sample or temp blank frozen? YES NfdK:gZ) <br /> 4. Were custody seals on outside of cooler? 42 _NO...NA <br /> If yes, how many and where:, (I)�p ul d- <br /> 5. Were the seals Intact,signed,and dated correctly? �NO...NA <br /> 6. Were custody papers Inside cooler? <br /> YES. :1�. .NA <br /> I certify that I opened the cooler and answered questions 1.6(Intiall <br /> 7. Were custody seals on containers: YES and Intact YES...NO... F� <br /> Were these signed and dated correctly? YES...NO...Q I <br /> 8. Packing mat'I used? Bubbiewrap P stic g Peanuts Vermiculite Ft Paper Other None <br /> 9. Cooling process: (2'cr� Ice-pack Ice(direct contact) Dry Ice Other None <br /> 10. Did all containers arrive In good condition(unbroken)? YES..,Q...NA I n VOA 604, <br /> 11. Were all container labels complete(#,date,signed,pres.,etc)? �E ...NO...NA •f 9f p"t'0 <br /> 12. Did all container labels and tags agree with custody papers? 1tQ...NO...NA <br /> 13a. Were VOA vials received? YQ...NO...NA rkr 13K, <br /> b. Was there any observable headspace present In any VOA vial? YES...I IQ...NA <br /> 14. Was there a Trip Blank In this cooler? YES..Ilyyr,..NA If multiple coolers,sequence# <br /> �� 5rohbq, <br /> I certify that 1 unloaded the cooler and answered questions 7-14(Intiall <br /> 15a. On pres'd bottles,did pH test strips suggest preservation reached the correct pH level? YES..NO..f� <br /> b. Did the bottle labels Indicate that the correct preservatives were used YfiS...NO...NA <br /> 16. Was residual chlorine present? YES...NO... <br /> lyyv <br /> I certify that I chocked for chlorine and pH as per SOP and answered questions 15-16(Intial) <br /> 17. Were custody papers properly filled out(Ink,signed,etc)? (R.INO...NA <br /> 18. Did you sign the custody papers In the appropriate place? `Fe�s...NO...NA <br /> 19. Were correct containers used for the analysis requested? - XE6...NO...NA <br /> 20. Was sufficient amount of sample sent in each container? Yt@S...NO...NA <br /> cerffy that I entered this project into LIMS and answered questions 7.20 Intial <br /> I certify that I attached a label with the unique LIMS number too each container(Intial) <br /> 21. Were there Non-Conformance Issues at login? YES...6�Was a PIPE generated?YES.>];�3>,.# <br /> BIS=Broken in shipment <br /> Cooler Rwelpt Fonn.doc LF-I Revised 624/09 <br /> PaBdA ' <br /> 9eOT48 12/22/2011 <br />