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The SeaCrest Group Sample Receipt Form Fom, #: a2 <br />Louisville, CO Effective: January 2003 <br />Project #: SOS) 3~ Sample #: `~ <br />Dater y.2~ 03 Initials: ~~, <br />Samples Were: <br />1. Shipped Hand Delivered essengered (circle one) <br />Notes: UPS <br />2. Airbill Present Y ~ NA <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />Ambie C I e <br />Ice Blue Ic <br />(circle one) <br />(circle one) <br />4. Aeration necessary Y ~ NA <br />Notes: <br />5. Cooler Received Broken or Leaking Y U NA <br />Notes: <br />6. Sample Received Broken or Leaking Y ~t NA <br />Notes: <br />7. Sample Properly Preserved Y ~ NA <br />Notes: (~ f q~ fpo GJ ~ ~M ~ tS~.3 I l <br />C sez hoc ~~ cc,N~e~~ ~~ <br />8. Received Within Holding Times Y N <br />Notes: <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter):n <br />eff: fl o ~, ~'7 - ~ bta z ~ cJ h ~'~i3h ~1n co /v ~ 5/~ y-f-l y a~q,r ~c oc(i~ /- <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 <br />4. Unbroken on Sample Y N <br />COC Record Was: <br />1. Present Upon Receipt of Sample ~ N <br /> DO Tem H CI <br />Eff /S.s' Y.2 A <br />Rec' <br /> <br />Time ~ DO ~ pl-i <br />Ce NL ~. g, <br />a <br />