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SA LE RECEIPT CLIENT: OEC Ill#: / �!`��� Temp: C <br /> Rev 01115/10 Acceptable Range: 0°C to 6°C <br /> COC.RECEIVED RECEIPT LOGIN / <br /> DATE/TIME: 08/1-7//2- /r�i�" DATE/TimE: 6,0/x-, 1(2- H'00 REFRIGERATOR(s): t�L�F c <br /> SAMPLE TRANSPORT,RECEIPT, CONDITION&PRESERVATION: Yes No N/A {*)PROBLEM CHAIN FORM NEEDED <br /> ❑OEC Courier/Sampler COC document(s)received with samples IN ❑* ❑ Custody Seals(circle): Present Absent . <br /> �Delivery(Other than OEC Courier) Correct containers for analysis requested 0 ❑* ❑ Samples/Coolers <br /> ❑Samples Received on ice Container(s)intact and in good conditio ❑* ❑ Intact/Broken* <br /> ❑Samples Received Outside Temp.Range* Container label(s)consistent with COc ❑ Method of Shipment&"tracking#t(irapplicable)- <br /> ❑Samples Direct from field(Outside Temp) OEC preservative added (**note std ID) ❑** ❑ Fer,107)C ?011 �S Z7j M-7 <br /> ❑After-Hours Outside Drop-off[Brought Inside] Proper preservation on sample label(s) ❑ ❑ X (**)OEC Preservative ID. <br /> (Initials/Date/Time): VOA containers free of headspace ® ®* 0 Dissolved Metals Filtration:(Datellnit/Preserve ID) <br /> Tedlar Bas free of condensation * <br /> CONTAINERS, COC CHANGES AND/OR CORRECTIONS CHANGES AUTHORIZED BY: <br /> OEC ID Client ID***If blank,refer to CoC Container Description Preservative ResCl Matrix Date/Time Comments/Remarks/ <br /> / H Sam led*** Condition Notes,Etc. <br /> RECEIPT LOGIN BY: t1 RECEIPT REVIEWED BY: Page of . <br />