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48/.1612046 15:24 FAX @055254�� FGL ENVIRONMENTAL ' � la olo1010 <br /> FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt {Attach to COQ <br /> Sample Receipt at STI{: <br /> 1. Number of ice chests/packages received,- <br /> 2. <br /> eceived;2. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Also acceptablc is rcceivcd 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 I'll check for tesn/H.T.'shushcstBacti's to <br /> prioritize further review. Please notify Microbiology personnel immodiately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? Yes No N/A <br /> 4. Were samples received intact? (i.e, no broken bottles,leaks etc.) Yes No <br /> i 5. Were sample custody seals intact? N/A Yes No <br /> i Sign and date the COC,place in a ziplock and put in the same ice chest as ther pies. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP; E <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to VC. If many packagcs arc rccriv€d at one time check for tests/H.T.'shushes/Bacti's ro <br /> prioritize further review. Please notify Microbiology personnel immc&tcly of b�ach'samples received <br /> i t <br /> 2. Do the number of bottles received agree with the COC? s es No N/A <br /> 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) Yes No <br /> 4. Were sample custody seals intact? ! Yes No <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 r 7 <br /> e e a requested analyses understood and acceptable? es No <br /> 2. Did bottle labels correspond with the client's ID's? es No <br /> 1� t <br /> 3. Were all bottles requiring sample preservation properly Preserved? No N/A FGL <br /> 4. Were all analyses within holding tin'-ics at time of receipt? es No <br /> 5. Have rush or project due dates been checked and accepted? l Yes No <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): � f <br /> Discrepancy Documentation: <br /> Any items above which are"No" or do not meet specifications (i:e.temps)must be resolved. <br /> 1. Person Contacted: Phone Number, <br /> Initiated By: _— <br /> Problem: (3-9574) _ -- -- <br /> NeII Werson & Associates <br /> Resolution: S TK 0 6 3 61 6 9 <br /> IV-07/24/ 00$-16:30:Q0 <br /> a- <br />