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COOLER RECEIPT NECKUST %. Curtis & Tompkins, Ltd. <br />Login# -Z-1w-'-- Date Received 2, -10 -1 Numberpf coolers /*' <br />Client dudzlt� Project <br />DateOpened . . i/,sl <br />I - Did cooler come with a shipping slip (airbill NO <br />Shipping in• <br />2A. Were custody seals present? . _. (circle onr�tiler�.- on samples ❑ NO <br />How many Z Name 54-ii�rl� Date <br />2B. Were custody seals intact upon arrival? NO N/A <br />3. Were custody papers dry and intact when received? NO <br />4. Were custody papers filled out properly (ink, signed, etc)? NO <br />5. Is the project identifiable from custody papers? (If so -,O out top of form) NO <br />6. Indicate the paclong in cooler: (if other, describe) G <br />le Wrap ❑ Foam blocks ags ❑ None <br />❑ ClothmaterW MCardboard ❑ Styrofoam ❑ Paper towels <br />7. Temperature documentation: <br />Type of ice used: ❑ Wet ❑ Blue/Gel tWcQe Temp(OC) <br />❑ Samples Received on ice & cold without a temperature blank <br />Q Samples received on ice directly from the field. Cooling process had begun <br />8. Were Method 5035 sampling containers present? <br />aRi <br />If YES, what time were they transferred to ? <br />9. Did all bottles arrive unbrokenhmopened? <br />NO <br />10. Are samples in the appropriate containers for indicated tests? <br />NO <br />11. Are sample labels present, in good condition. and complete? <br />OM NO <br />12. Do the sample labels agree with custody ? _ <br />NO <br />13. Was sufficient amount of sample sent for tests requested? <br />NO <br />14. Are the samples appropriately preserved? <br />YES NO <br />15. Are bubbles > 6mm absent in VOA samples? <br />YES NO <br />16. Was the client contacted concerning this sample delivery? <br />YES NO <br />If YES, Who was called? By <br />Date: <br />AVJ <br />SOP Volume. Client Services Rev. 6 Number 1 of 3 <br />Section: 1.1.2 Effective: 23 July 2008 <br />page: 1 of 1 Z:\gc\forms\checklists\Cooler Receipt Checklist rv6.doc <br />4 of 17 <br />