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2 <br />r) <br />t� <br />FGL Enviromuental <br />Revision Date: 10/23/07 <br />Doc ID: F3REC005.004 <br />Page: I of 1 <br />Stockton - Condition Upon Receipt (Attach to COC) <br />Sample Receipt at STK: <br />1. Number of ice chests/packages received: <br />2. Were samples received in a chilled condition? Temps: 1 ! I I <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 immediately ofbacti samples received.. <br />3. Do the, number of bottles received agree with the COC?) No NIA <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes 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 thE7aTples. <br />Sample Rec,Ieipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: I l I 1 <br />Acceptable is above freezing to 6° C. if many packages are received at ane time check for testsM.T.VrushcsBacti's to <br />prioritize further review. Please notify Microbiology personnel immediately of batt! samples received. <br />2. Do the number of bottles received agree with the COC?g'N/ <br />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 rind Distribution: <br />1. Were all requested analyses understood and acceptable? Yeti No <br />2. Did bottle labels correspond with the client's ID's? Ye No <br />3. Were all bottles requiring sample preservation properly preserved? Yes No / , FGL <br />4, VOAslchecked for Headspace? Yes No /A <br />5. Were all analyses within holding times at time of receipt? es No <br />6. 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 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: Phone Number: <br />Initiated By: Date: <br />Problem: <br />' <br />Resolution:�:.r''-%` <br />w� <br />