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",a2 <br />seaCrestGroup Sample Receipt Form Form <br />Effective December #:42 <br />Louisville, Co <br />Project 2- <br />Date: _ 2a t? <br />Samples Were: <br />1. Shipped -viand Delivere Messengered <br />3. Chilled to Ship <br />Notes: <br />Sample #: <br />Initials: <br />(circle one) <br />Ambient le one) <br />Wet Ice ^lue Ice clr a one) <br />4. Cooler Received Broken or Leaking Y NA <br />Notes: <br />5. Sample Received Broken or Leaking Y r NA <br />Notes: <br />6. Received Within Holding Times N <br />Notes: <br />7. Aeration necessary Y N, NA <br />Notes: <br />8. Sample Received at Temperature between 0-60 C . N NA <br />Notes: <br />9. Description of Sample (Color, Odor, nd/or Presence of Particulate Matter): <br />eff: <br />rec'g <br /> Aeration <br />Temp DO (m tL) DO %sat H Cond Time DO (m /L) DO (%sat) H <br />Eff <br />Rec' <br />Custody Seals: <br />1. Present on Outer Package Y <br />Y <br />N <br />2. Unbroken on Outer Package <br />3. Present on Sample Y ?-N-) <br />4. Unbroken on Sample Y N NA <br /> <br />Custody Documentation: <br />1. Present Upon Receipt of Sample N