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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: n `1 <br /> . Number of ice chests/packages received: 'u7 <br /> 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/rushes/Bacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? I es No N/A <br /> 4. Were samples received intact?(i.e.no broken bottles, leaks etc.) Yes 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 thmpI <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 one time check for tests/H.T.'srmshes/8acti'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? 1. <br /> �) No N/A <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) �0 No <br /> 4. Were sample custody seals intact? IyGA 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? 6r2s No <br /> 2. Did bottle labels correspond with the client's ID's? Y�s) No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No 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 delivii <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documentation:Any items above which are"No" or do not meet specifications(i.e. temps) resolved. <br /> I. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> t3-..6:'3t <br /> Resolution: <br /> StAes Farms <br /> STK0732865 <br /> S;1T-03/30/20J�- <br />