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FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 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: HOZ <br /> 2. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROT)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/I4.T.'s/mshes/Bacti'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? fNo N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No5. Were sample custody seals intact? Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the sg�ples <br /> Sample Receipt Review completed by (initials): (y� <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 teaot4i,T.'9/n,nhes/Bacti's to <br /> prioritize ftnther review. Please notify Micmbiololy personnel immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? 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? No <br /> _ 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? 9Yes No FOL <br /> 4. Were all analyses within holding times at time of receipt? 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): U <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: (3-13102) <br /> Precision Enviro-Tech <br /> Resolution: STK 0 6 3 0 417 <br /> IV-01/13/2006-09:09:12 <br />