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FGL Environmental Doc ID: F3REC005.005 <br /> Revision Date: 2/13/09 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> I. Number of ice chests/packages received: &;CT <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/rushesBacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of b es received.. <br /> 3. Do the number of bottles received agree with the COC? o N/A <br /> 4. Were samples received intact?(i.e.no broken bottles. leaks etc.) No <br /> 5. VOAs checked for Ileadspace? oNLA <br /> 6. Were sample custody seals intact? Yes No N/A <br /> Sign and date the COC. place in a ziplock and put in the same ice chest as the an les. <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 check for <br /> tests/ll.T.'s/rushesBacti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacti 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.) es No <br /> 4. Were sample custody seals intact? Yes No N/ <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? Yes No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4. VOAs checked for Ileadspace? es No N/A <br /> 5. Were all analyses within holding times at time of receipt? Yes No <br /> 6. Have rush or project due dates been checked and accepted? Yes No I�1//A <br /> Attach labels to the containers and include a copy of the COC for lab delivee : <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 /> I. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: (3-15419) <br /> Chesney Consulting <br /> STK1139867 fere <br /> SRP-11/08/2011-16:32.2 <br /> 0 <br />