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1 FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition { <br /> Receipt Upon Attach to COC) <br /> p p <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. Also acceptable is received on ice(ROI)for the same day of sampling or <br /> received at room temperature(RRr)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 ofbacti samples 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.) Ye No <br />' i 5. Were sample custodyseals intact? NIA Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the s�les. <br /> a Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 1 I 1 1 <br /> { Acceptable is above freezing to 6°C. If many packages are received at o e time check for tests/H.'r.'s/rushes/Hacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. <br /> f <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.) a No <br /> _ 4. Were sample custody seals intact? N/ 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? 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 NIA FGL <br /> _. 4. Were all analyses within holding times at time of receipt? es No <br /> i S. Have rush or project due dates been checked and accepted? Yes No <br /> A <br /> Attach labels to the containers and include a copy of the COC for lab del' <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: <br /> Problem: , <br /> i iinfIf1rfi n+ \r;� i iriA r)s fi.i { 1lLiiif - i`ilJf <br /> GResolution: } <br /> �.. ._s w m <br />