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FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt(attach to CCC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: <br /> 2. Were samples received in a chilled condition? 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(R.RT)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.'shushes/Bacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? (EM No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) Yes No <br /> 5. Were sample custody seals intact? N/A es No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as t 1ples. <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 tests/H.T.'shushes/Bacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of hood 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.) `i;� ', No <br /> 4. Were sample custody seals intact? N/ 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 /> 1. Were all requested analyses understood and acceptable..? es No <br /> 2. Did bottle labels correspond with the client's ID's? e No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> 4. Were all analyses within holding times at time ofrereipt? No <br /> Have rush orprojea, due (fintes been checked and rccepted? Yes NJ <br /> Allach labels to the.containers and 'include a copy of the COC for lab delivery. <br /> Sample Receipt,Login and Verification completed by(initials): <br /> 13isrt epx�nrp l)ot•untenlauon: <br /> .I N ile ufi abcvt w1w it ,ue "1�n" OF till mit nH-rl sh�rriit< , ,isua� li.e iemprl n'ntst lu tr-snlvtd <br /> 1'rteun t �u,te,tirii: '=hone Iduml�tr <br /> Iniii.ttr�iB <br /> i'tol�irn, <br /> (3-2839) <br /> ke.,t't"i,n; Alpine Packing Company <br /> STK0639671 <br /> IV-11/14/2006-11:42:18 <br /> e <br />