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tlFGL Environmental Doc ID: F3REC005.001 <br /> Revision Date: 10/20/00 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: <br /> 2. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Note as AOI(arrived on ice)if chilling was begun for samples received on <br /> same day of sampling. <br /> 3. Do the number of bottles received agree with the COC? Y No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? A Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the samples. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for tests/H.T.'s/rushesBacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? S No N/A <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 4. Were sample custody seals intact? Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? es No <br /> 2. Did bottle labels correspond with the client's ID's? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4. Were all analyses within holding times at time of receipt? es No <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> Any items above which are "No" or do not meet specifications (i.e. temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 3010955 <br /> Holz Rubber Co. <br /> STK232485 <br /> Temp: ,V,�'1I /�-I I 1 1 <br />