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FGL Environmental Doc ID: F3REC005.005 <br /> Revision Date: 2/13104 Page: I of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: / <br /> 2. Were samples received in a chilled condilion? Temps: —/ / ( / <br /> Acceptable is above freezing to 6°C. Also acceptable is received 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 time check for tests/H.T.'s/rushesBacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of be les received.. <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles. leaks etc.) Yes No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No N/ <br /> Sign and date the COC. place in a ziplock and put in the same ice chest as dseTm <br /> Sample Receipt Review completed by(initials): / <br /> 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 <br /> tests[H.T.'s/rushes/Bacti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? No N/A <br /> 3. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 4. Were sample custody seals intact? No (!A <br /> Sign and date the COC.obtain LIMS sample numbers, select methods/tests an abets. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? EYes <br /> No <br /> 3. Were all bottles requiring sample preservation properly preserved? 1)(4n No N/A FGL <br /> 4. VOAs checked for Headspace? es No N/A <br /> 5. Were all analyses within holding time,at time of receipt? Ye No <br /> 6. Have rush or project due dates been checked and accepted? Yes No <br /> Attach labels to the containers and include a copy ofthe COC for lab d� <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> Any items above which arc"No"or do not meet specifications(i.c, temps)must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date:. <br /> Problem: <br /> Resolution: (3-16608) <br /> Live Oak Geo Environmental <br /> STK1134351 <br /> N145-05/24/2011-12:15:35 <br />