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FGL Environmental Dare ID: 1F3R C'OOi.a05 <br /> Revision Date: 2/13/09 Page: 1 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: <br /> Acceptable is above freezing to 6°C. Also acceptable is rcceiti ed on ice(ROI) for the same day of sampling or <br /> received at room mmperanve(RRT)if sampled within one hour of receipt. Client contact for temperature failures <br /> must be documented below. If many packages arc received at one time check far tests/MT.TrushcsBacti`s to <br /> prioritize further review. Please notify Microbiology personnel in-imediately ofba l les 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.) VeNo <br /> j. VOA5 checked for Ileadspace'? o <br /> 6. Were sample custody seals intact'? Yes No NIA <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the sat s. <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 /> testSrl-i.T.'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 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 dine the COC, obtain LLMS sample numbers, select methods/tests and print labels, <br /> Sample Verification, Labeling and Distribution: <br /> I_ Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? Y No <br /> 3. Were all bottles requiring sample preservation properly preserved? Ye No N/A FGL <br /> 4, VOAs checked for I--Ieadspace? Ye No N/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 GN// <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <br /> Sample Receipt. Login and Verification completed by(initials): 7�R <br /> Discrepancy Documentation: <br /> Any ilczm above which art'"No"or do riot meet specifications(ite,temps)must be resolved. <br /> 1, Person Contacted; _ Phone Numbcr.� <br /> Initiated By; -- Date: <br /> Problem: <br /> Resolution; .l (3V`r—v166600) <br /> ijiaa OkRIVir0117 <br /> "L i <br /> STK1035325 <br /> SRP-06/16/2010-11:41:32 <br />