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SAMPLE RECEIPT CLIENT: G'AL �P "cy_C OEC ID#: 12.0 � Temp: ° C <br /> Rev 01/15/10 Acceptable Range: 01C to 6eC <br /> COC RECEIVED RECEIPT LOGIN ®� <br /> DATE/TIME: a-�f-{ 102—S DATE/TIME: `7` Y`' fl Z- G6 qO REFR.IGERATOR(s)• "S C4/--Q/ <br /> SAMPLE TRANSPORT,RECEIPT, CONDITION&PRESERVATION: Yes No N/A (*)PROBLEM CHAIN FORM NEEDED <br /> ❑OBC Courier/Sampler COC document(s)received with samples ❑* ❑ Custody Seals(circle): Present/( bsent <br /> r "Delivery(Other than OEC Courier) Correct containers for analysis requested ❑* ❑ Samples/Coolers <br /> ❑Samples Received on Ice Container(s)intact and in good condition ❑* ❑ Intact/Broken* <br /> ❑Samples Received Outside Temp.Range* Container label(s)consistent with COC ❑* ❑ Method-of Shipment&Tracking/kil'applicable). <br /> ❑Samples Direct from field(Outside Temp) OEC preservative added (**note std ID) ❑** ❑ El F'6007#"6bOf' 4'5�q <br /> ❑After-Hours Outside Drop-off[Brought Inside) Proper preservation on sample label(s) ❑ ❑ K (**)OEC Preservative ID. <br /> (Initials/Date/Time): VOA containers free of headspace ❑ ❑* � Dissolved Metals Filtration:(I.)aLL/Init/Preserve IU) <br /> Tedlar Bams free of condensation ❑ ❑* IE�& <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 /> /pH Sam led*** Condition Notes,Etc. <br /> RECEIPT LOGIN BY: RECEIPT REVIEWED BY: Z►d/ Page of_L <br />