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05/27/04 THP 14:32 FAd 305 5V 4172 FGL ENVIRONyENI'L 2009 <br /> FGL Environmental Y <br /> Revision Date: 10/11/02 IlocIP )1aREC005.002 <br /> Page:-1 of 1 <br /> .Stockton -Condition Upon eceipt (Attach to•COQ <br /> Sample Receipt at STK: <br /> L Number of ice chests/packages received: 3 <br /> 2. Were samples received in a chilled condition? Temps: 2Z ,24,22.I. <br /> Acceptable is above freezing:to 6°C. Also acceptable is received on ice(10(51)for the same day of aerr>pling or <br /> received at room tenmerattlre(RRT)if sampled within one hour-of receipt, Client contact for tempetatt>rhug o res <br /> most be dotumeatcd below, if many packages are received at one time check for testwEF _r.,aIrusltes/gacti'a to <br /> Prioritize further review. Please notifyMicrobieloBY Perstmnel immediately of baeti IM 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.) No <br /> 5. Were sample custody seals iii tact? <br /> / Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice cliest e s lam, <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable it above freezing to 6°C. lfmany packages ace received at one time check for te-sts/H.T.'s!rushesrBaai's:o <br /> prioritize further review. Please notify Microbiology personnel icmnedimay ofhacti 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- <br /> 4- Were sample custody seals intact? /1�? 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 colTespond.with the client's ID's? Ie No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <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 deli <br /> Sample Receipt,Login and.Veri iicationcompleted by(initials): �Discrepancy -F— <br /> Documentation:. <br /> Any items above which are'No"or d0 sot meet specifieations (i.e. temps)must be resolved. <br /> 1. Person_Contacted: phone Number: <br /> By: Date: <br /> Problem: —` ------ <br /> Resolution (3-2343) ———--� <br /> Clark Well Inc, <br /> STK0433371 <br /> 88-05/18/2004-09:26:18 <br />