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SeaCrest Group Sample Receipt Form <br />Louisville, CO <br />Project #: ?; Z J <br />Date: Gc)ko IO <br />Samples Were: <br />1. Shipped HMessengered <br />Notes: <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 />Form *: 42 <br />Effective: December 2008 <br />Sample #: Z <br />Initials: <br />(circle one) <br />Ambient hilted (circle one) <br />et Ice Blue Ice (circle one) <br />Y NA <br />1 ? <br />Y 8 NA <br />(5 N <br />7. Aeration necessary YJ NA <br />Notes: <br />8. Sample Received at Temperature between 0-60 C . Y (ND NA <br />Notes: s??.C_ aka`„ "z,' t I % 1 <br />9. Description of Sample (Color,, Odor, and/or Presence of Particulate Matter): <br />eff: <br />rec'g <br />Aeration <br />Temp DO m /L DO %sat) H Cond Time DO m /L DO %Sat H <br />Eff 16.b (/),-I -'? S Z -7, 140--l <br />Custody Seals: <br />1. Present on Outer Package Y N <br />2. Unbroken on Outer Package Y NA <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N NA <br />Custody Documentation: <br />1. Present Upon Receipt of Sample N