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I.. FGL Environmental Doc ID: F2REC005.009 Revision Date: 4/07/04 Page: 1 of 1 Santa Paula - Condition Upon Receipt (Attach to COC) Sample Receipt: r 1. Number of ice chests/packages received: _!___—_ Note as OTC if received over the counter unpackaged. 2. Were samples received in a chilled condition? Temps: Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROI) for the same day of sampling or received at room temperature(RRT) if sampled within one hour of receipt. Client contact for temperature failures must be documented below. If many packages are received at one time check for tests/H.T.'s/rushes/Bacti's to prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. 3. Do the number of bottles received agree with the COC? es, No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No 5. Were sample custody seals intact? N Yes No Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. Sample Verification, Labeling and Distribution: 1. Were all requested analyses understood and acceptable? Yes No 2. . Did bottle labels correspond with the client's ID's? e No 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL 4. Were all analyses within holding times at time of receipte No 5. Have rush or project due dates been checked and accepted? N/ Yes No Attach labels to the containers and include a copy of the COC for lab delivery. Sample Receipt, Login and Verification completed by(initials): Discrepancy Documentation: Any items above which are "No" or do not meet specifications (i.e. temps) must be resolved. 1, Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: 2. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: - (3-15419) Chesney Consulting STK0639839 IV-11/14/2006-12:45:54