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The SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville; CO ERective: November 2D03 <br />Project # <br />Date: ~, <br />Samples Were: <br />1. Shipped <br />Notes: <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />~> ~~~ <br />~-r ~ 5 <br />Hand Delivered <br />u S <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 />Ambie le one) <br />le one) <br />Y <br />Y \ <br />s'-` ~1 <br />Y <br />-. <br />nt Chilled, (circ <br />Blue Ice (circ <br />NA <br />CN NA <br />N <br />NA <br />8. Sample Received at Temperature between 0-6° C . Y <br />Notes: <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />rec'g <br /> DO Temp pH CI <br />Eff ~.~\ `-a ~ . Etin <br />Rec'g <br />COC Tape Was: <br />1. Present on Outer Package Y N <br />2. Unbroken on Outer Package Y N <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N <br />Sample #:_ <br />Initials: <br />essenger d (circle one) <br />Y % N ± NA <br />N NA <br />Time .~ DO ~ pH <br />0 <br />m <br />a <br />~~ <br />^~~ <br />COC Record Was: <br />1. Present Upon Receipt of Sample ~ N <br />