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<br />SeaCrest Group <br />Louisville, CO <br />e2 ' <br />Project #: D <br />Date: _ <br />Samples Were: <br />1. Shipped <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />Sample Receipt Form Form 0: 42 <br />?(:)9Z-I <br />IZ 0 <br />(liand Delivereit Messengered <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 />Effective: December 2008 <br />Sample #: <br />Initials: df. <br />(circle one) <br />Ambient q`hilled'`, (circle one) <br />Inlet Ieq Blue Ice (circle one) <br />Y ) NA <br />Y ?N } NA <br />C--, <br />lY N <br />7. Aeration necessary Y N NA <br />Notes: ` <br />8. Sample Received at Temperature between 0-60 C . Y r'N NA <br />Notes: ?'o e.\??e ?? o n \e..e ?rtitY?? c o o? , Sc?? ?e <br />9. Description of Sample (Color, Odor, and/or Presence of Particulate Matter): <br />eff: (?-01p,c t e s S VLQ '? Vn <br />rec'g <br />Custody Seals: <br />1. Present on Outer Package Y L <br />2. Unbroken on Outer Package Y N N <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N <br />Custody Documentation: <br />1 . Present Upon Receipt of Sample I ` Y N