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FGL Environmental Doc 11): h2RECOO=,01C• <br /> Revision Date: 4/07/04 Page: I of 1 <br /> Santa Paula - Condition 1_:pon receipt (.Attach to COQ <br /> Sample Receipt: �r <br /> I . Number of ice chests/packages received: <br /> Non:as OTC i f received over the counter unpackaged. <br /> 2. Were samples received in a chilled condition? Temps: 4// <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/rushes/Bac Li's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. <br /> ;. 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.) No <br /> 5. 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 /> I. Were all requested analyses understood and acceptable? Y No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> ;. Were all bottles requiring sample preservation properly preserved? Yes No tTl_IP PGI.. <br /> 4. Were all analyses within holding times at time of receipt? a No <br /> 5. Have rush or project due dates been checked and accepted? 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): <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: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated By: Date: _ <br /> Prohlem: <br /> Resolution: <br /> ^P 0708135 <br /> :4 <br /> Page 18 of 18 07/24/2007 <br />