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FGL Environmental n Doc ID: F3REC005.002 Revision Date: 01/20/04 Page: 1 of 1 Stockton - Condition Upon Receipt (Attach to COC) Sample Receipt at STK: IIE 1. Number of ice chests/packages received: &T 2. Were samples received in a chilled condition? Temps: 1 /-/-/ Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROI)for the same day of sampling or r received at room temperature(RRT)if sampled within one hour of receipt. Client contact for temperature failures must be documented below. If many packages are received at one time check for tests/RT.'s/ushes/Bacti's to prioritize further review. Please notify Microbiology personnel immediately ofbacti samples received., t 3.' Do the number of bottles received agree with the COC? ge No NIA f r 4. Were samples received intact?(i.e.no broken bottles,leaks etc.) No 5. Were sample custody seals intact? Yes No Sign and date the COC,place in a ziplock and put in the same ice chest as pies. ' Sample Receipt Review completed by(initials): M Sample Receipt at SP- I. P:I. Were samples received in a chilled condition? Temps: I I 1 I 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 Fji' prioritize ftu•ther review. Please notify Microbiologypersonnel immediately of bacti samples received. 2. Do the number of bottles received agree with the COC? es No NIA 3. Were samples received intact? (i.e. no broken bottles,leaks etc.) Ye No 4. Were sample custody seals intact? Yes No ' FF Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. . Sample Verification,Labeling and Distribution: 1. Were all requested analyses understood and acceptable? es No ' 2. Did bottle labels correspond with the client's ID's? No 3. Were all bottles requiring sample preservation properly preserved? No NIA FGL 4. Were all analyses within holding times at time of receipt? No 5. Have rush or project due dates been checked and accepted? Yes No t � Attach labels to the containers and include a copy of the COC for lab delivery. t Sample Receipt,Login and Verification completed by(initials): Discrepancy Documentation: p Y Any items above which are"No"or do not meet specifications (i.e.temps)must be resolved. I. Person Contacted: Phone Number: + Initiated By: Date:_. Problem: (3-12023)F, , 15u1tinq Resolution: L��o�� & Scalmat��nx 5TK0 6 3 4 414 TV-06/01/2006-08'-45104