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FGL Environmental Doc ID: <br /> y F3REC005.002 . .f <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> i Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: L� <br /> 2. Were samples received in a chilled condition? Temps: I I 1 I <br /> Acceptable is above freezing to 6°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 further review. Please notify Microbiology personnel immediately of batt' pies received.. <br /> 3. Do the number of bottles received agree with the COC? es No NIA <br /> 4. Were samples received intact? (i.e.no broken bottles, leaks etc.) No <br /> E 5. Were sample custody seals intact? Yes No <br /> I 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): �y <br /> Sample Receipt at SP: <br /> Fill1. Were samples received in a chilled condition? Temps:Acceptable is above freezing to 6°C. if many packages are received at one time check for tests/H.T.'s/rushes/Bacti'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? es No - N/A <br /> 3. Were samples received intact?(i.e. no broken bottles,leaks etc.) es No <br /> F4. Were sample custody seals intact? Yes No <br /> F+ Sigh and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> C Sample Verification,Labeling and Distribution: . <br /> I. Were all requested analyses understood and acceptable? es No <br /> lF 2. Did bottle labels correspond with the client's ID's? a No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> F4. Were all analyses within holding times at time of receipt? a No <br /> r 5. Have rush or project due dates been checked and accepted? Yes No <br /> 1 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 /> F F Discrepancy Documentation: <br /> Any items above which are"No"or do not meet specifications(i.e. temps)must be resolved. <br /> I. Person Contacted: Phone Number: <br /> ° ' Initiated By: Date- <br /> Problem: (3-12023) <br /> Resolution. Luhdorff & Scalmanini Consulting <br /> 3 STK0631392 <br /> TV-02/ 6/2006-09:38:0'7 <br /> � 1 <br />