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Thy SeaCrest Group Sample Receipt Form Form #: az <br />Louisviile, CO Effective: November 2003 <br />Proyect #: ` <br />Date: _~ <br />Samples Were: <br />1. Shipped <br />Notes: <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />~ ~-( l <br />Hand Delivered <br />~j~l <br />4. Cooler Received Broken or Leaking <br />Notes: <br />5. Sample Received Broken or Leaking <br />Notes: <br />6. Received Within Holding Times <br />Notes: <br />7. Aeration necessary <br />Notes: <br />Sample #: <br />Initials: / <br />(circle one) <br />Y ~~~ N <br />8. Sample Received at Temperature between 0-ti° C . <br />Notes: <br />NA <br />Ambient hilted (circle one) <br />Ice, Blue Ice (circle one) <br />Y N NA <br />Y ~ N,4 <br />(/ N <br />Y / N . / NA <br />N NA <br />9. Description of Sample (Color, Od r, and/or P esence of Particulate Matter): <br />eft: S ~ a ~1~~ (-; c ~~.-~ ; ~ ~~ ~ ~ ~ ~ i yn{ ti cn ~~ <br />rec'g <br /> DO Temp pH CI <br />Eff -7 -~ z _ L 2.5 Yv <br />Rec'g <br />COC Tape Was: -~ <br />1. Present on Outer Package Y <br />2. Unbroken on Outer Package Y <br />3. Present on Sample Y N <br />4. Unbroken on Sample Y N <br />Time ~ D~ ~ pH <br />m <br />a <br /> <br />COC Record Was: ~ <br />1. Present Upon Receipt of Sample Y N <br />