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0 <br />COOLER RECEIPT CHECKLIST <br />Login # 740'0- fZ 3'0- Date Received 2 —(G —10' <br />Client /Y-/ ZE _ <br />Date Opened - d- By (print)5; . <br />Date Logged_ By <br />1. Did cooler come with a sbipping slip (airbill, etc) <br />Shipping info -7)*3;7--_ g <br />C] <br />Number <br />Curtis & Tompkins, Ltd. <br />NO <br />2A. Were custody seals present? . _ �'Y M (circle o <br />on samples ❑ NO <br />How many Z Name 'S%&ic4"7A05r- <br />Date 0-47-4a <br />2B. Were custody seals intact upon arrival? <br />NO N/A <br />3. Were custody papers dry and intact when received? <br />NO <br />4. Were custody papers filled out properly (ink, signed, etc)? <br />NO <br />5. Is the project identifiable from custody papers? (if so 0 out top of form) _LITS> NO <br />6. Indicate the packing in cooler. (if other, descnlc) ` '� <br />NO <br />EEM <br />Bubble Wrap ❑ Foam blocks 'hags <br />❑None <br />❑ Cloth material hardboard ❑ Styrofoam <br />❑ Paper towels <br />7. Temperature documentation: <br />Type of ice used: ❑ Wet Q Bhm/Gel ;Mkge, Temp(°C) <br />❑ Samples Received on ice & cold without a temperature blank <br />❑ Samples received on ice directly from the field. Cooling process had began <br />8. Were Method 5035 sampling containers present?. -YES^ <br />. <br />If YES, what time were they transferred to freezer? <br />9. Did all bottles arrive unbrokenhanopened? <br />NO <br />10. Are samples in the appropriate containers for indicated tests? <br />NO <br />11. Are sample labels present, in good conditionand complete? <br />CM NO <br />12. Do the sample labels agree with custody papers? <br />NO <br />EEM <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 NOS' , <br />16. Was the client contacted concerning this sample delivery? <br />YES NO <br />If YES, Who was called? By <br />Date: <br />FAO WA WE i! <br />SOP Volume: Chem Services Rev. 6 Number I of 3 <br />Section: 1.1.2 Effective: 23 July 2008 <br />Page: I of 1 Z:\gc\formskbecklists\Cooler Receipt Checklist rv&doc <br />