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SeaCrest Group Sample Recei <br />Louisville, co Receipt Form <br />Project #: k 0 <br />Date: <br />Samples Were: <br />1. Shipped ' Hand Delivered 'j Messengered <br />otes: ' <br />3. Chilled to Ship <br />Notes: <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 />Form *: 42 <br />Effective: December 2008 <br />Sample #: <br />Initials: -- <br />(circle one) <br />Ambie Chilled (circle one) <br />eW t Iced Blue Ice (circle one) <br />Y NA <br />Y NA <br />(.?._---?' N <br />Y <br />8. Sample Received at Temperature between 0-60 C . Y <br />Notes: <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />eff: CoI[) S5, cc(carw,5/ PG PM <br />rec-g <br />t,ustoay Seals: <br />1. Present on Outer Package Y (T <br />2. Unbroken on Outer Package Y N NA <br />3. Present on Sample Y LN_) <br />4. Unbroken on Sample Y N NA <br />Custody Documentation: <br />1. Present Upon Receipt of Sample N <br />c <br />NA <br />NA