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V <br /> COOLER RECEIPT FORM <br /> Log No: <br /> Cooler receive on: a4Qan c ec a on by <br /> si a ure <br /> mere custody papers present' . . . . . . . . . . . . . . NO <br /> 4ere custody papers properly filled out's . . . . . C�F NO <br /> mere the custody papers signed? . . . . . . . . . . NO <br /> 4as sufficient ice used" . . . . . . . . . . . . . . . . . YE NO D <br /> s , nor <br /> Did all bottles arrive in good condition (unbroken) ' . . . . YES. NO `J <br /> Did bottle labels match COC'7 . . . . . . . . . . . . . . . . . . . . . . . . . YE NO <br /> ,dere proper bottles used for analysis indicated? . . . NO <br /> Correct preservatives used? . . . . . . . . . . . . . . . . . . NO <br /> VOA vials checked for headspace bubbles? . . . . . '. YE, NO <br /> Note which voas ( if any) had bubbles : * <br /> Sample descriptor Number of vials <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis . . . . . . . . . . . . YES NO <br /> L,ist here all other fobs received in the same cooler <br /> Tient Job # NET log # <br /> (coolerrec) <br />