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DEC-14-2007 09: 13 From: To:209 GGe 2598 P.2'14 <br /> otl/QV/kVv( 1!)'YH Flex 8055254172 F6L ENv2RDNNE 1AL IM 012/01? <br /> FGL EnAmameuW DOCIDI <br /> F3REC005.002 <br /> Revteton Daae: 01/20/04 Page: l of 1 <br /> Stockton - Condition Upon Re pt(Attach to COCA <br /> Sample Receipt at STK: <br /> 1. Number of ice cbesWpaekagos received: <br /> 2, Were sttcnplas received in a chilled condition? TengA,: <br /> Aatepmble is above freezing to 6"C. Also areeptabk is iced 4cd iso(ROi ft tea w; day of ding or <br /> rocci«d st roe®6eatperglurc( 7�if emsytod Wftbm ostn hrns of�oo�t C1i®t ooirwt for temperonim En u w <br /> must be dnc=c2ftd below. If many padaiges are roreivnd nt ono tome chink&w msta4LT.'sh 4bft/8acL'e a <br /> ptdorttize faiths tt;vicw. Pleeac�►tify 1.ticr+Db�ology per�ottnek idmtedlntclY of tinct]!1m>�yka racavcd.. <br /> 3. Do the number of bottles reoeived agree with the COQ? NO N/A <br /> 4. Were senVies recrivefl irrract?(i.e. no broken bottles, 1l! a"etc.) No <br /> 5. Were sample cumdy seals intact? /A Yea No <br /> Sign and date the COC, place in a ziplock and put in the se ice chest as SS- <br /> Sample Sample Rept Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1 Were samplas received in a chilled condition? Ttan <br /> Awcpmwc ig above$eanxj8 to 6°C. rf maty padmgw aroruamv..edI-81 ono tAm Obod[For tESts/ J.'yNy M44ari's to <br /> totem furtbv mvww, Pies=twdA'b 1wobkology persmunel an lY of bws nmies Mocived <br /> 2. Do the number of bottles received armee with the CW No N/A <br /> 3. Wem samples rweived intact?(i.e, no broken bottles, leaks etc,) No <br /> 4. Wert sample custody 861119 intact? Yes No <br /> Sign and date the COC,obtain LLMS sample numbers, select methods tmu and priTu lsb6ls. <br /> Sample vtwifte2tioo,Labeling and Divtrlbtrilon; <br /> 1. Wore ail requested analyses understood and aeceptablf No <br /> 2. Did bottle labels correspond with the client's UO No <br /> 3. Were all bottles mquriug umpic preservubon pmpc7l preservod? GY� No N/A FGL <br /> 4. Wero all analyses within holding times at time of read t? Xe No <br /> 5. Have rush or projoct da dates been checked acid ecc I ted? N/ Yes No <br /> Attach labels to the contain and include a copy of the COC for lab delivery. <br /> sample Reoeipt,login and Verification omnpletod by(initia�): �t3 L- <br /> i <br /> Diecrepaocy Documentation; <br /> Any items above which are"No"or do not mcet sperillesti (i.e, temps)must be resotvcd. <br /> 1. Person Contacted: Phone Number: <br /> Initiated 13y: Aare: <br /> Problem: <br /> (3-16659 <br /> Resolution; Keith Grass *11s & Pups <br /> STK0736601 <br /> Zv--07/23/2007-09:25101 <br />