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FGL Environmental Doc ID: <br /> t F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> i. Stockton - Condition Upon Receipt (Attach to COC) <br /> �t Sample Receipt at STK: /� <br /> 1 i 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 received on ice(ROn 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 bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? X,, es <br /> No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No <br /> 1 Sign and date the COC, place in a ziplock and put in the same ice chest as am les. <br /> Sample Receipt Review completed by (initials): <br /> 1+ 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 tests/H.T.'s/rushes/Bacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. <br /> 1 <br /> 2. Do the number of bottles received agree with the COC? (Yes No N/A <br /> '} 3. Were samples received intact?(i.e. no broken bottles, leaks etc.) Ye No <br /> 4. Were sample custody seals intact? � Yes No <br /> r� Sign and date the COC,obtain LM1S sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> Fii 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? (Y� No <br /> i 3. Were all bottles requiring sample preservation properly preserved? Yes No j�A FGL <br /> 4. Were all analyses within holding times at time of receipt? �s No �J <br /> 5. Have rush or project due dates been checked and accepted? (gk Yes No <br /> A Attach labels to the containers and include a copy of the COC for lab delive <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> r� Any items above which are "No"or do not meet specifications (i.e. temps) must be resolved. <br /> 1. Person Contacted: Uhnne Number: <br /> Initiated By: (3-9574) <br /> Problem: Nell Anderson & Associates <br /> Resolution: S TK a 7 3 815 7 <br /> -1 SJT-09/05/2007-16:15:18 <br /> ("1 <br />