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ASSO TED LABORATOAMS <br /> 806 North Batavia-Orange, California 92868-1225- 7141771-6900 FAX 7.141538-1209 <br /> Cooler Receipt Form <br /> Client , Project 7L C� ( 72- <br /> Date <br /> 72-- <br /> Date Cooler Received: . i'� Date Cooler opened: <br /> Was cooler scanned for presence of radioactivity 9 Yeco <br /> If yes was radioactivity results above 25 cpm ? Y <br /> Was a shipper's packing slip attached to the coder? �s1No <br /> If the cooler had custody seals),were thy'signed and intact? �—e o/Na <br /> Was the cooler packed with- Ice_ _ Ice`Packs Bubble wrap. <br /> Styrofoam Paper None Other <br /> Cooler Temperature• <br /> *cooler needs to be received @ 4°C with an acceptable range of 2°-6°C <br /> If samples were hand delivered do they meet the temp criteria,which should be °C with <br /> an acceptable range of 2°- 6 'C ? ee <br /> If no explain. <br /> Were all samples sealed in plastic bags ? Se No <br /> Did all samples arrive intact?If no, indicate below. CYes/No <br /> Were all samples labeled correctly ? (ID's Dates,Times)If no, indicate belowYes/No <br /> Can the tests required be ran with the provided containers,If no indicate below.CYes/No <br /> Was sufficient sample volume sent for all containers ? e o <br /> Were any VOA vials received with head space? Yesl�/o a <br /> Was the correct preservatives used? es o/Na <br /> If no,see the pH log for a list of samples containers regarding pH <br /> Any other important uiforrnation. <br /> Rereivmg Department. Date 3j��� <br />