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me oeaCrest Group Sample Receipt Form Forma: az <br />Louisville, CO Efl~ective: November 2003 <br />Project #: ~oa? ~'Z <br />Date: o~?a,;~~~1 <br />Samples Were: <br />1. Shipped Hand Delivered ~(vle5sengered~ <br />Notes: ~-. _ __ ---' <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />4. Cooler Received Broken or Leaking <br />Notes: <br />cE <br />Chilled (circle one) <br />Ice Blue Ice circle one) <br />Y ~ NA <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 />8. Sample Received at Temperature between 0-(i° C . Y ~N~ NA <br />Notes: ~~// <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />eff: B~N>sw <br />C.n~°~t~ .5tr~tHT c3r~~m~~,C. 5.~.z\\~ MP~~uw. P.v~ <br />rec'g <br /> DO Temp pH CI <br />Eff ~.q Iti."u ~. N,'? <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 />Sample #: <br />Initials: ,~P <br />(circle one) <br />Y ~> NA <br />Time ~ DO ~ pH <br />o r-- <br />m <br />`m <br />a <br /> <br />COC Record Was: <br />1. Present Upon Receipt of Sample ~''Y } N <br />