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Doe ID: <br /> is FGL Environmental <br /> F3REC005.002 Page: 1 of 1 <br /> Revision Date: 01/20/04 <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 b°C. Also acceptable is received on ice(ROI)for the same day of sampling or <br /> received at room temperature(RRT)if sampled within one hour of receipt. Client contact for temperature failures <br /> must be documented below. if many packages are received at one time check for tests/H.T.'s/rushesBacti's to <br /> prioritize farther review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? Yes No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> 5. Were sample custody seals intact? NIA Yes No <br /> FJSign and date the COC,place in a ziplock and put in the same ice ches as t e mples. <br /> j Sample Receipt Review completed by (initials): <br /> 1 <br /> r <br /> Sample Receipt at SP: <br /> 3. Were samples received in a chilled condition? Temps: / / <br /> Acceptable is above freezing to 6°C. if marry packages are received at one time check for tests/H.f.'skushesBacti'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? TeNo NIA <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) ryes` No <br /> 4. Were sample custody seals intact? IAS Yes No <br /> p <br /> Sign and date the COC, obtain L1MS sample numbers, select methods/tests and print labels. <br /> 1 F <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? 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 /> i 4. Were all analyses within holding times at time of receipt? es No <br /> 4 <br /> 5. Have rush or project due dates been checked and accepted? NIA Yes No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <br /> i <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 /> I. Penson Contacted:__-- Phone Number:___.__-_ <br /> InItiated.Dy: Date: <br /> Problem-. 574) <br /> f ' Resolutionâ–º: Neil Anderson & Associates <br /> STK0639364 <br /> IV-10/31/2406 <br /> -09:37:44 <br /> i '-' <br />