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The SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville, CO Effective: November 2003 <br />Project #: 5 a ~ ' / / Z <br />Date: ~ .S i Z ~' s <br />S. Shippe Hand Delivered Messengered <br />Notes: UPS <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <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 NA <br />8. Sample Received at Temperature between 0-6° C . <br />Notes: <br />Ambient hilted (circle one) <br />Ice Blue Ice (circle one) <br />Y ~ NA <br />Y ~ NA <br />N <br />Y ~ NA <br />N NA <br />9. Description of Sample (Color, Odor, andJor Presence of Particulate Matter): <br />eff: Gi.Fntcf1w~rtrGi,uvprr~¢sJ ~ rvwcv°« Gtci~'7 ~,~n-t(L <br />t <br />rec'g <br /> DO Temp pH CI <br />Eff CP. '3 I • S- ~ <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 ~i <br />4. Unbroken on Sample Y N <br />COC Record Was: ~ <br />1. Present Upon Receipt of Sample ~ N <br />`o T~ D~ pH <br />a <br />~N ^' <br />I~ <br />