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r <br /> ASSOCIATED LABORA TOMES <br /> 806 North Batavia Orange, California 928681225- 714177.1-000 F7 415381204 <br /> Cooler Receipt Form <br /> Client. D ' Project. 7 <br /> Date Cooler Received. -- -2A Date Cooler <br /> Opened: <br />----- -Was cooler,scanned for presence-ofradioactivitty-?If yes was radioactivity results above 25 cpm ? YeSIII <br /> Was a shipper's packing slip attached to the cooler ? ye&(ICo <br /> If the cooler had custody seal(s),were thy signed and intact? r Y [No/Na <br /> Was the cooler packed with-Ice, Ice Packs Bubble wrap <br /> Styrofoam Paper None Other <br /> 0 <br /> Cooler Temperature: 3, 0 C- <br /> *cooler needs to be received @ 4°C with an acceptable range of 20- 5 °C <br /> If samples were hand delivered do they meet the temp. criteria, which should be @ 4°C with <br /> an acceptable range of 2 -6 °C ? es/No <br /> If no explain <br /> Were all samples sealed in plastic bags ? <br /> Yes7No <br /> Did all samples arrive intact?If no, indicate below. (!e!No <br /> Were all samples labeled correctly? (ID's Dates,Tunes)Ifno, indicate below es o <br /> t Can the tests required be ran with the provided containers, If no indicate below. Ye o <br /> Was sufficient sample volume sent for all containers ? <br /> Ge 2qo <br /> Were any VOA vials received with head space? <br /> Yes(�gNa <br /> Was the correct preservatives used V <br /> If no,see the pH log for a list of samples containers regarding pH ------ <br /> A-AY other important information: <br /> Receiving Department-_-___ Date <br />