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The SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville, CO EKective: January 2003 <br />Project #: 'S~,',~? `.> I <br />Date: ' j•'v~<~'ti <br />Samples Were: <br />1. Shipped Hand Delivered ~Messengere~""~ <br />Notes: .BPS <br />2. Airbill Present <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />4. Aeration necessary <br />Notes: <br />5. Cooler Received Broken or Leaking <br />Notes: <br />6. Sample Received Broken or Leaking <br />Notes: <br />7. Sample Properly Preserved <br />Notes: ~ c~ ° / <br />8. Received Within Holding Times <br />Notes: <br />Sample #: ~- <br />Initials: ~, <br />r <br />(circle one) <br />Y ~Tl NA <br />Ambi ent ill~d~ (circle one) <br /> <br />I`c Blue Ice (circle one) <br />Y ~N~ NA <br />Y ~ ~ NA <br />Y ~IV~. NA <br /> ~l <br />Y ~~ NA <br />~~ N <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br /> eff:,p~~~ sl.'~t^,f- ~. ;~,1;z ~,:i ,f <br />-~ ~,1M~s+ ul.~; {-` ;.~,~, ,~L y~.~,,t. <br /> rec'g <br />C OC Tape Was: <br />1. Present on Outer Package Y ~~J; <br />2. Unbroken on Outer Package Y N <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N ~N,4 <br />COC Record Was: <br />1. Present Upon Receipt of Sample ~ N <br /> DO Tem H CI <br /> <br />Rec' <br />Time ~ DO ~ pH <br />0 <br />a <br />