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SeaCrest Group Sample Receipt Form Form #: 42 <br />Louisville, CO Effective: December 2008 <br />Project #: 3? Sample #: -'2 <br />Date: (2-3 1 t Initials:` <br />Samples Were: <br />1. Shipped Hand Delivered' Messengered (circle one) <br />?? <br />Notes: <br />3. Chilled to Ship <br />Notes: <br />Ambient Mlle (circle one) <br />Wet Ice BQ lue Ice ) (circle one) <br />4. Cooler Received Broken or Leaking Y I NA <br />Notes: <br />5. Sample Received Broken or Leaking Y 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 . Y ON) NA <br />Notes: Sc-AY?_` cA, a. np 1?'??? <br />9. Description of Sample (Color, Odor, and/or Presence of Particulat e Matter): <br />eff: (I ASS DY I ess, vw <br />'01 l'/L1 <br />rec'g <br /> Aeration <br /> Temp DO (m rL) DO %sat) H Cond Time DO (m /L DO (%sat) H <br />Eff -, Z <br />Rec' <br /> <br />Custody Seals: <br />e Y <br />Outer Packa <br />1 <br />P <br />t <br />?N <br />g <br />on <br />. <br />resen <br />2. Unbroken on Outer Package Y N <br />3. Present on Sample Y <br />4. Unbroken on Sample Y N NA <br />Custody Documentation: <br />1. Present Upon Receipt of Sample UY N