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FGL Environmental Doc ID: F3RFC005.005 <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: T <br /> 2. Were samples received in a chilled condition? Temps: J/ <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 inunediately,of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? e No N/A <br /> 4. Were samples received intact?(ix,no broken bottles. leaks etc.) No <br /> 5. VOAs checked for Ileadspace? es No N/A <br /> 6. Were sample custody seals intact? Yes No A <br /> Sign and date the COC. place in a ziplock and put in the same ice chest sant 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/1l:r.'s/rushes/Bacti'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.) No <br /> 4. Were sample custody seals intact? f No N/A <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 correspond with the client's ID's? 9 No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> :1. VOAs checked for Headspace? Yes No / <br /> 5. Were all analyses within holding times at time of receipt? (�'" 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 delivefry. n <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.c.temps)must be resolved. <br /> 1. Person Contacted:_. Phone Number: <br /> Initiated By: - <br /> Problem: <br /> Resolution: <br />