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Cooler Receipt Form <br />ANALYnCA <br />Client: Colorado Division of Reclamati Client Code: 501304 <br />Project: M-1977-300 <br />Cooler ID: 1 <br />A. Preliminary Examination Phase: Date cooler opened: 9114/2010 <br />Cooler opened by: NL <br />1. Was airbill Attached? N/A Alrbill #: <br />2. Custody Seals? WA How many? 0 Location: <br />3. Seals intact? N/A <br />4. COC Attached? Yes Properly Completed? Yes <br />5. Project Identification from custody paper: M-1977-300 <br />6. Preservative: Wetlce Temperature: 5.9 deg. C <br />Designated person Initial here to acknowledge receipt: <br />COMMENTS: <br />Order #: 81009086 <br />Signature: L2 t_ <br />Carrier Name: Client <br />Seal Name: <br />Signed by AEL employee? Yes <br />NL Date: i r Lill 0 <br />B. Log-In Phase: Samples Log-in Date: 9/1412010 Log-in By: NL <br />1. Packing Type: Ice <br />2. Were samples in separate bags? N/A <br />3. Were containers intact? Yes Labels agree with COC? Yes <br />4. Number of bottles received: 4 Number of samples received: 1 <br />5. Correct containers used? Yes Correct preservatives added? Yes <br />6. Sufficient sample volume? Yes <br />7. Bubbles in VOA samples? N/A <br />8. Was Project manager called and status discussed? No <br />9. Was anyone called? No Who was called? <br />COMMENTS: <br />By whom? Date: <br />Page 1 of