Laserfiche WebLink
ASSOCIATED LABORATORIES <br /> 806 North Batavia - Orange, California 92868-1225- 7141771-6900 FAX 714/338-1209 <br /> Cooler Receipt Form <br /> Client 'r"1)1-i t') Project <br /> i <br /> Date Cooler Received. ! %y Date Cooler Opened /III b:5-- <br /> Was <br /> .rWas cooler scanned for presence of radioactivity Yes <br /> If yes was radioactivity results above 25 cpm Yes o <br /> Was a shipper's packing slip attached to the cooler /No <br /> If the cooler had custody seal(s), were thy signed and intact ? YeslNo/Na <br /> Was the cooler packed with. Ice Ice Packs Bubble wrap <br /> Styrofoarn Paper None Other <br /> f <br /> Cooler Temperamre <br /> *cooler needs to be rec:ived @ dor with an acceptable range o'2a_ 6 °C <br /> if samples were hand deli-ci'td do they mtW t the Terrip cattna., titch should bn C A'C vT ith <br /> an acceptable range of 2°- 6 °C <br /> If no explain <br /> Were all samples sealed in plastic bags 9 C-Yes/No <br /> Did all samples arrive intact ?If no, indicate below e/No <br /> Were all samples labeled correctly ? (ID's Dates, Times) If no, indicate below (::Y�6 s/No <br /> Ca. the tests required be ran.with Ehe provided containers, If no indicate bele'.V QY,s/No <br /> Was sufficient sample volume sent for all containers ? CYe's/No <br /> Were any VOA vials received with head space ? Yes/l'(4'o/Na <br /> Was the correct preservatives used ? ��Yes/No/Na <br /> If no, see the pH log for a list of samples containers regarding pH <br /> • Any other important information <br /> Rece Tin? Departrent Date J Jli i <br />