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03/0212007 16: 10 FAX 8055254172 FGL ENVIRONMENTAL [0012/012 <br />{ i FGL Environmental Doc H1: <br /> )F3REC005.002 <br /> Revision Date:01/20/04 Page: 1 of 1 <br /> Stockton -Condition Upon Receipt(Attach to CCC) <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 filing to 6°C. Also acceptable is received on ice(ROI}for the same day of sanviing or <br /> received at roam 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 tests5l T.'s/rushes/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? No N/A <br /> 4. Were samples received intact?(i.e_no broken bottles,leaks etc.) Y No <br /> 5. Were sample custody seals intact? N/A Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the�iles. <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 chock for testa/H.T.'shusheyBacti's to <br /> prioritize further review- Please notify Mierobielegy personnel inunediatcly of bacti swrxples 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 /> I. Were all requested analyses understood and acceptable? 4�0 <br /> o2. Did bottle labels correspond with the client's ID's? <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No IYGL <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? 19 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): - - <br /> Discrepancy Documentation: <br /> Any items above which are`No"or do not meet specifications(Le.temps)must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By. - <br /> Problem: (3-9574) <br /> Nei i Anderson & Associates <br />� <br /> Resolution: <br /> STK0731330 <br /> IV-02/09/2407-10:49:37 <br />