Laserfiche WebLink
i <br /> TestAmerlca <br /> ANALYTICAL TESTING CORPORATION <br />' Nashv;Elle Division <br /> COOLER RECEIPT FORM BC# <br /> Client 347487 <br />' Cooler Received On 9119103 And Opened On 9119103 i By: Mark Beasley <br /> /M U7 <br /> (Signature) <br /> 1 Temperature of Cooler when opened 0 Degrees Celsius <br />' ? Were custody seals on outside of cooler? {- 65R NO NA <br /> a If yes, now many,what land and where <br /> 3 Were custody seals on containers and intact? NO YES NA <br /> 4 Were the seals intact, signed, and dated correctly? 'F ' NO NA <br />' 5 Were custody papers inside cooler' (YDE NO NA <br /> 6 Were custody papers properly filled out(ink,signed,etc)'' YES NO NA <br />�• 7 Did you sign the custody papers in the appropriate place? CTS!)NO NA <br /> $ What kind of packing material used Bublilewra Peanuts Vermiculite Other None <br />' 9 Cooling process: Ice pacl Ice(direct contact) Dry ice Other None <br /> 10 Did all co-tainei- %r.iv�in unotl `oF dirioz:( i;nbrokeii)' T N�; <br /> 11 Were all container labels complete(#,date,signed,pres,etc.)9 ``[� NO NA <br /> 12 Did all container labels and tags agree with custody papers' - _. NO N4 <br /> 13 Were correct containers used for the analysis requested' �E�' NO NA <br /> 14 a Were VOA vials received' NO NA <br /> b Was there any observable head space present in any VOA vial? TO , YES NA <br /> 15 Was sufficient amount of sample went in each container' 'ES NO NA <br /> 16 Were correct presiervatives used? ES NO NA <br /> If not, record standard M of preservative used here <br /> 17 Was residual chlorine presents NO` YES NA <br />' 18 See attached for resolution of non-4-ontormance <br /> UPS Velouty kirborne Route Off-street F Mise <br /> Cooler Rcceiot Form LF-1 913/03 <br /> End of Farm <br />