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Tne SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville, CO Effective: November 2003 <br />Project #: ~py3pq Sample #: <br />Date: L„~py Initials: ~Q <br />Samples Were: <br />1. Shipped Hand Delivered Messenger d (circle one) <br />Notes: <br />2. Airbill Present Y ~ NA <br />Notes: <br />3. Chilled to Ship Ambie nt hille (circle one) <br />Notes: <br /> ce Blue Ice (circle one) <br />4. Cooler Received Broken or Leaking Y ~ NA <br />Notes: <br />5. Sample Received Broken or Leaking Y jFl~ NA <br />Notes: ~~JJ <br />6. Received Within Holding Times ~ N <br />Notes: <br />~. Aeration necessary Y /N~ NA <br />Notes: ~~// <br />8. Sample Received at Temperature between 0-6° C . ~ N NA <br />Notes: <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />eff: Gec+.~, no ocfbr, m~rcrr ~pn <br />rec'g <br /> DO Temp pH CI <br />Eff ~n.tv 5.0 ~.~ <br />Rec'g <br />COC Tape Was: <br />1. Present on Outer Package Y <br />2. Unbroken on Outer Package Y N <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N <br />Time ~ DO ~ pH <br />0 <br />d <br />a <br />~T <br />\J <br />COC Record Was: <br />1. Present Upon Receipt of Sample ~ N <br />