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The SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville, CO Effective: November 2003 <br />Project #: 3G3 ~f 17 <br />Date: i Z - 2- a3 <br />Samp~es Were: <br />~Y. Shipped> Hand Delivered Messengered <br />--~ Notes: G~ hS <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />4. Cooler Received Broken or Leaking <br />Sample #: ~` <br />Initials: ~~/~?)~ <br />(circle one) <br />Y U NA <br />Ambte Chilled (circle one) <br />1~/~- Ice Blue Ice (circle one) <br />Y ~ NA <br /> Notes: <br />5. Sample Received Broken or Leaking Y ~ NA <br /> Notes: <br />6. Received Within Holding Times ~ N <br /> Notes: <br />7. Aeration necessary Y ~ NA <br /> Notes: <br /> ''~~~ <br />8. Sample Properly Preserved Y lpV NA <br /> Notes: <br />9. Description of Sample (Color, Odor, and/o r Presence of Particulate Matter): <br /> eff: Grow J I've 0~...- ~ IVd ~ ~, <br />rec'g <br /> DO Tem H CI <br />Eff $:C> rE, ~~ g, l 7/l~ <br />Rec' <br />COC Tape Was: <br />2. Unbroken on Outer Package <br />3. Present on Sample <br />4. Unbroken on Sample <br />COC Record Was: <br />1. Present Upon Receipt of Sample <br />Time ~ DO ~ pH <br />o ~ <br />a <br />N <br />