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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: <br /> i <br /> i 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(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 inunediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? NIA Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the si ples. <br /> Sample Receipt Review completed by (initials): <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 tests/H.T.WrushesBacti'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? Yes No N/A <br /> 3. Were samples received intact? (i.e. no broken bottles,leaks etc.) es No <br /> 4. Were sample custody seals intact? / Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tes print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? es 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? s No N/A FOL <br /> 4. Were all analyses within holding times at time of receipt? es No <br /> 5. Have rush or project due dates been checked and accepted? /A e No <br /> Attach labels to the containers and include a copy of the COC for lab delive . <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: <br /> {3-15419} <br /> Initiated By: <br /> Problem: Chesney Consulting <br /> Resolution: STK0636303 <br /> IV-07/26/2005-74:22:07 <br /> :re <br />