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The SeaCrest Group Sample Receipt Form Form #: a2 <br />Louisville, CO Effective: January 2003 <br />Project #: ~~~~~ <br />Date: 11- -~~_ <br />Sams-ire: <br />. Shipped Hand Delivered Messengered <br />Notes: <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />4. Aeration necessary <br />Notes: <br />Y <br />Sample #: <br />Initials: ~-_ <br />(circle one) <br />NA <br />------~ <br />Am 'en hilted 'circle one) <br />G- .~- <br />~~~+e 4ee-~eire4e one) <br />Y .r~ NA <br /> <br />5. Cooler Received Broken or Leaking Y ~ NA <br /> Notes: <br /> <br />6. Sample Received Broken or Leaking Y /~ NA <br /> Notes: ~' <br />\ / <br /> r~ <br />7. Sample Properly Preserved Y ~ N~ NA <br /> Notes: •J <br /> <br />8. Received Within Holding Times Y N <br /> Notes: <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br /> eff: tt ~ ~ <br />R-GCi:.1 C,If~~ <br />GjC:niL <br />\ Cl x'72 <br />j t q <br />~1~\ <br /> rec'g <br />CCC Tape b^Jas: <br />1. Present on Outer Package <br />2. Unbroken on Outer Package <br />3. Present on Sample <br />COC Record Was: <br />1. Present Upon Receipt of Sample <br />Y ~ vL~' <br />Y ~N NA ~' <br />Y r\'~' - <br />_ - :.~__ t <br />~~ N <br /> DO Tem H CI <br />Eff ~ r (G - ~ Ss'. 3 J~''~ <br />Rec' <br />Time ~ DO ~ off <br />Q <br />