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LA <br /> ka A SS 0 CIA TED LAB ORA TORITE S <br /> l Orth Batavia - orange, California 92865-1225- 7141771-5900 FAX 7141538-1209 <br /> Cooler Receipt Farm <br /> Client _--�� Project —D 17 <br /> Date Cooler Received Date Cooler Opened i j 3 y <br /> Was cooler scanned foz presence of radioactivity ? Yes <br /> If yes was radioactivity results above 25 cpm ? Ye o <br /> Was a shipper's packing slip attached to the cooler Cyes/No <br /> F <br /> If the cooler had custody seal(s), were thy'signed and intact Ye 'o/Na <br /> Was the cooler ,packed im-d—i Ice �Ice hacks Bubble wrap <br /> tyrazoam Paper None Othei <br /> Cooler Temperature <br /> cooler reeds 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 ramge of 2°_ 6 OC ? Yes o <br /> If no e<xplain <br /> Were all samples sealed in plastic bags Ge-SINO <br /> Did all samples arrive intact ?If no, wcheate below (felNo <br /> Were all samples labeled correctly ? (ID's Dates, Tines) if no indicate below 0slNo <br /> Can the tests required be ran with the provided containers, If ao indicate below C�/No <br /> Was sufficient sample volume sent for all containers ? esNO <br /> Were any VOA vials received with head space ? Yes12�la <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 information <br /> • <br /> Receiving Department r Date <br />