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02107/0i TRT 17!02 j,dJ ":]Q05 <br /> FGL Un ironmental Doe IDS: <br /> F3RE0005.002 <br /> Revision Date:01.20/09 page: A of I ®� <br /> Stackton-Condition Upon Receipt(Attach to cCOC) <br /> Sample Receipt at STK.- <br /> 1. <br /> TI.:1. Number of ice chests/p a okages received: <br /> 2. Were samples rc, cdved in a chilled.condition? Temps: <br /> Acceptable is above ft mina to 6'C. Also ncocptable is received on ice(ROTI-,or the same day of sampling or <br /> ieceivcd at room tempenwt (RRA if sampled within ane hour of receipt. Clizat coritao:frit te:apetanir.failures <br /> immt be doo=nbid below. If malty packages ate received atone time check for teats'FL';.'iixitehes/IIneti's to <br /> prioritize furtter mvigv. Please notify Microbiology pmraounei iatmcdiamly of batt±samples r vived. <br /> 3_ Do the number of bottles received agree with the COC? I'm ' No N/A <br /> 4. Were sampler received intact:?(i.e.no broken bottles,leaks eta.) Y � AVO <br /> 5. `Were sample cmtody seals intact? Pt Yes Pvo <br /> Sipa and date the COC,plac.in a ziplock and put in the same ice eheFt as thT! -)let;. <br /> Sample Receipt Review w>mpletcd by(initials): ' <br /> Sample:Receipt at SP- <br /> 1. 'N e�a samples rec�eiYved,in a chilled condition? Temps: / I <br /> llrrelKable iS abwC ll'--'Writ 20 6°�, of N81fy paeltugec%irC S[CCl�'E'd ffi PnC ESee CECSk ter ICS��t't.S.'&NF1iG4n.Ctl'F eP <br /> tciaiors f�uthcr revL:vr. Plcaa�:,roofy ntiaobiPiogperrannel itraacdiatttY PPbadt smm�l�a r=dyed. <br /> 2. Do the number o bottle:,received agree with the COM N/A. <br /> 3. Were samples=Rived intact?(i.e.nO broken bottles leaks etc.) No <br /> 4. there sample excstCaiy seals intact? IXes No <br /> Sign and date the COC,obtain LII.IS sample numbers, select methods/tcsts and print labels. <br /> Sample Verification,Labeling,and Distribution: <br /> I. 'li'crc all requcstod anCyges understood and acceptable? i ' Y No <br /> f. <br /> 2 Did bottle labels cozy_spond with the,client's ID's? i its No <br /> 3. 'Nene all battles reyuirtag sample p enervation properly pros ezv�['t` �'�" No NIA FG), <br /> within holding times at time of roodpt? "� No <br /> 4. Ut ere all analyse g P ' -� <br /> S. ]iavc rush or proiect due dates been checked and accepted? (L` No <br /> An&labPIs to the coptainers and include a copy of the COC for lab Clehverp. � <br /> Sample Receipt,Login and\re6fication completed by(initials): <br /> Discrepancy Documentation, <br /> Any ite!ns above wmea are;"No7 or do not meet specifications(i.e.temps)rust be Msolwd, <br /> 1. Person Contacted.:__._ Phone _--- <br /> Initaated Bv: Date:...,—_—= <br /> Problem: <br /> Rcaoludonc Neil Anderson & Associlifiil�s <br /> STKU635396 e <br /> IV-OG/30/200f—i5:3S:19 <br />