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„ r <br /> I i <br /> ' rr <br /> JU <br /> --- ASSOMTED-L"ORATD"ES�-� �- - - - -� —_—`---- — ---- -- <br /> 806 Noah Batavia-Orange, California 928681225- 7141771=6900 <br /> FAX 714138-1209 <br /> Cooler Receipt,Form <br /> Client .ti_� ,7 -Ll' �- <br /> Date Cooler Received. ? L_ Date Cooler Opened 71 l <br /> Was cooler scanned for presence of radioactivity ? Ye&w, —” <br /> If yes was radioactYvity results above 25 cpm ? y <br /> Was a shipper's packing lisp attached to the cooler? esNo <br /> If the-cooler had custody seal(s),were thy signed and intact-? Yes/Na ' r - <br /> *yr <br /> Was the cooler packed with: lee Ince Packs Bubble wrap <br /> Styrofoam Paper None Other <br /> V <br /> Cooler Temperature- C, <br /> *cooler needs to be received a@ 4°C with an acceptable range of 2°-6 °C - w <br /> If samples were hand delivered do they meet the temp criteria, which should be -4°C with <br /> an acceptable range of 20- 6 °C ? YesslNo <br /> lfno explain.: <br /> Were all samples sealed in plastic bags ? V __ __ CY4NO <br /> Did all samples arrive intact?If no, indicate below. S 0 <br /> Were all samples labeled correctly ?(ID's Dates, Times)If no,indicate below C!s/No <br /> Can the tests required be ran with the provided containers, If no indicate below, LCVNO - <br /> Was sufficient sample volume sent for all containers 7 <br /> Yes/No <br /> Were any VOA vials received with head space? Yes/ Na <br /> Was the correct preservatives used ? Qallo/Na <br /> If no, see the pH log for a list of samples containers regarding pH <br /> Any other important information: <br /> Racenring Depairentdate %!(. <br />