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FGL Environmental Doc ID: <br /> F3RECOOS.002 <br />' Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br />€, <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: <br /> 2. Were samples received in a chilled condition? Temps: I I I 1 <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 testsB.T.'s/rushesBacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately ofbacti samples received.. <br /> i <br /> 3. Do the number of bottles received agree with the COC? (Z5 No NIA <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ye No <br /> i <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 les. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: l I I I <br /> Acceptable is above freezing to 6'C. 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 bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? e ; No NIA <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 /> F 1. Were all requested analyses understood and acceptable? es No <br /> 2. Did bottle labels correspond with the client's FD's? es o <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> , <br /> 1 4. Were all analyses within holding times at time of receipt? No <br /> F 5. Have rush or project due dates been checked and accepted? Yes No <br /> 4 <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): <br /> Discrepancy Documentation: <br /> t Any items above which are "No"or do not meet specifications (i.e. temps)must be resolved. <br /> r 1. Person Contacted: Phone Number: <br /> Initiated By: <br /> Problem: (3-9570 <br /> 'eil Ander sops & ASSoc i ales <br /> .; Resolution: <br /> -V-02/09/2007-!0:49:37 <br /> Fil <br />