Laserfiche WebLink
ASSOCI MID LABORATORIES <br /> W06 North:Batavia-Orange, California 92868-1225- 714/771-6904 PAX 714153&1209 <br /> Cooler Receipt Form <br /> Client: � � � Pro}cit: <br /> Date Cooler Ra;eived: Date Cooler Opened: <br /> Was cooler scanned for presence of radioactivity ? Yo <br /> If yes was radioactivity results above 25 cpm? Y o <br /> Was a shippees packing slip attached to the cooler? o <br /> If the cooler had custody seal(s),:rice <br /> gz�dand intact?Was the cooler packed with:Ire Parks Bubble wrap <br /> Styrofoam Paper____Now Other <br /> Cooler Tempemture: ` <br /> `cooler needs to be received @ 4°C oath an acceptable range of 2°-6'C <br /> If samples were hand delivered do tboy meet the temp.Criteria,which should bo @ 4 frith <br /> an acceptable range of 2°-6 °C? y o <br /> If no explain: <br /> Were all samples sealed in plastic bags? LyePNO <br /> Did all samples arrive Waal?If no,indicate below. 4 <br /> 9 <br /> Were all samples labeled correctly? (ID's Dates,Times)If no,indicate below. o <br /> Can the tests required be ran with the provided containers,If uo indicate below. Q <br /> Was suffimeat sample volume sent for all containers? o <br /> Were any VOA vials received with head space? Y QNa <br /> Was the correct preservatives used? YeS17 <br /> a <br /> If no, see the pH log for a list of samples container$regarding pH <br /> Any other important information: ' <br /> t,- <br /> Receiving Department: Date- - --.- <br />