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1 <br /> 1 <br />' ASS'OCIAT'ED LABORAT'OMES <br /> 806 North Bat=ia-Orange, California 92868-1225- 714/77.1-6900 FAX 7141538-1209- <br /> Cooler Receipt Form <br /> -Client, Project: ` bC. 17/ <br /> Date Cooler Received: — _ 31 y9/05' Date Cooler Opened: 3 18 S <br /> Was cooler scanned for presenm of radioactivity ? Ye <br /> If yes was radioactivity results above 25 cpm? Ye� <br /> Was a shipper's packing slip attached to the cooler 9 Y o' <br /> If the <br /> cooler had custody seal(s),were thy signed and intact <br />' Was the cooler packed with: Ice Ice Packs Bubble wrap <br /> Styrofoam Paper None Other <br /> Cooler Temperature: c- <br /> *cooler needs to be received as 4°C with an acceptable range of 2°-6 °C <br /> If samples were hand delivered do they meet the temp. cntena,which should be °C with <br /> an acceptable range of 2°- 6 "C ? o <br /> If no explain: <br /> I �� <br />' Were all samples sealed in plastic bags ? (Yes/No <br /> Did all samples arrive intact?If no, indicate below. �Q4No- <br />' Were all samples labeled correct) ? {ID's Dates Times If no indicate below. <br /> Y`es/No <br /> Can the tests regured be ran with the provided containers, If no indicate belowYes/No <br />' Was sufficient sample volume sent for all containers ? No <br /> were any VOA vials received with head space? Yes/ To�Na <br />' was the correct preservatives used (YjkNo/Na <br /> If no, see the pH log for a list of samples containers regarding H <br /> P g gP <br /> Any other unportant mformatxon. <br /> Rec:wing Department Date 2i� <br />