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f I� f FGI..-Eavironrnentai Doe lam:F3REC005.Ut14 Revision bate. 10/23/07 Page: 1 of 1 Stockton - Condition Upon Receipt (Attach to COC) Sample Receipt at STK: I. Number of ice chests/packages received: , 2• Were samples received in a chilled condition? Temps: Acceptable is above 11M47ing to G°C. Also acceptable is received on ice(ROI)for the sante doy bf sstxnpling or received at room temperature(ljt-r)if sampled within one hour of receipt• ciiexit contact for temperature failures rrntst be documented below. If many packages are received at ane time check for te51s/H.T,'s/rusheslMacti1s to Prioritize farther review. ]'lease nofify Microbiology persomel immediately of hada sanVleS received,. 3. Do the number of bottles received agree with the COC? I I . No N/A 4. W=samples received intact9(i-c.no broken bottles, leaks etc.) es No 5. Were sample custody seals intact? E N/A. )Yes No ; Sign and date the COC,place in a ziplock and put in the same ice chest ase Sample RecP y b (initials). pieeipt Review completeds. Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps: Acceptable is above freezing io G°C_ ifrnany packages are received at nnc lime check fbr tests/F{.7,'s/rushesJBacti's to prioritize further review. Please notify MierobiolM personnel irm ediatcly otbacii sarripics rcccivad. 2. Do the number of bottles received agree with the COC? SCe No N/A 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) a No 4. Were sample custody seals intact? /A Yes No } Sign and date the COC,obtain LIMS sample numbers,select Methods/tests;aW print Iabels. Sample Verification,Labeling and Distributiou: 1. Were all requested analyses undcrstood and acceptable? a No 2. Did bottle labels correspond with the client's ID's? es No 3. Were all bottles requiring sample presetvation properly preserved? es No N/A FGL 4, VOAs cheeped for Readspace? es No NIA 5, Were all analyses within holding times at time of receipt? es No 6. Have rush or projact due dates been checked and accepted? Yes No Attach labels to the containers and include a copy ofthc COC for tab delivery, Sample Receipt, Login and 'Verification completed by(initials): Discrepancy Documentation; Any iterns above which are"No"or do not meet specifications(i.e. temps)must be resolved, I, Person Contacted: Phone Number; a Initiated By: ---�- , Problcrn: Nail t Resolution: 11a 1 l Mders0n & Associates I STKO852575 IV-12/�.b/?OU9-ii'.52:53 f;