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The SeaCrest Group Sample Receipt Form roan u: az <br />Louisclle, CO Effective: November 2003 <br />Project#: a~,5`~~j <br />Date: 11 /Zi %G 3 <br />Sample~Were: <br />1`Shipp~ Hand Delivered Messengered <br />~~ Notes: ~//'S <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 />8. Sample Properly Preserved <br />Notes: <br />Y <br />Sample #: 'ice <br />Initials: -, M;~~ <br />(circle one) <br />N ~~ <br />Ambient hilted (circle one) <br />Ice Blue Ic (circle one) <br />Y N NA <br />Y ~L1.J NA <br />N <br />Y ~ NA <br />Y ~ NA <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />eff: Uzu j i''-~"'-' ~ N.y U ~-,- _ ~ , f' ~`"l. ', C~~U,,, d ,% <br />rec'g <br /> DO Tem H CI <br /> <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 />_. <br />~~ <br />Time DO H <br />0 <br />a <br />N NA <br />N <br />N NA <br />N <br />