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806 North Batavia- Orange, California 9.2868-1295- 7141771-6100 F 714/53,8-1209 <br /> Cooler Receipt Form <br /> Client Project <br /> Date Coolvr Recenvad-_1?1? - �� Date Cooler Opened- 21 <br /> Was cooler scanned for presence of radioactivny '� Yes a <br /> If yes was radioaetiviiy results above 25 cpm 7 Ye /No <br /> Was a shipper's packmg shp attached to the cooler <br /> if the cooler had custody seal(s),were thy sagged and intact ? /-2)/No/Na <br /> Was the coaly packed wvath %cv_ ✓ inti Fadi., ubale varap---- <br /> �t.)�ofaaan paper iVone fur <br /> Cooler 'J"tM _PraXUre <br /> . cooler ntt_ts tolx- received C;:dor- wi h an a e^" t e 2- 01'21 6 o <br /> 1t sampitsvcr+1 hand --red ,0 he—Y Mi _t ttLv YE',Mp cniucaSYYe� ich should i- V-;a) VVIIAh <br /> an ac:eTptavit range o- 2°- 6 �C �o <br /> If no vixplam <br /> Were all sample, scaled m plasnc bags ? (:fpsq0 <br /> Did all samples armve intact ? Ifno, m irate baiow Ywafl�io <br /> Fere all samples. labeled correcdy ry (ID`s Daces, 1 amus' If no, an.d,.cate below CY,-�INO <br /> Can the. tests re-q --ed Ile rte!,Agth the prCrwawWd conta ie;rs, if no in€�Iw:,e belo�JCY s/-NC' <br /> Was sufficierii samplw volume sent for all cantame-rs '� (::�'es/�. O <br /> Were any VCA vials received with head space 9 Y:e,sNTo/Na <br /> Was the coaY-_ct preservatives used ? Yes/-No/ <br /> If no, see the pH log for a last of samples containers regarding pH <br /> Any other Mponarit information <br /> Recelring Deparltrnent j'� late <br />