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FGL Environmental Doc ID F3REC005.002 <br /> .Revision Date 10/11/02 Page 1 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 condition? Temps <br /> Acceptable is above freezing to 6° C AIso 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/Bacti's to <br /> prioritize further review Please notify Microbiology personnel immediately ofbacti samples received <br /> 3 Do the number of bottles received agree with the COC9 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? Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the samples <br /> Sample Receipt Review completdd 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 atone time check for tests/H T'sTmshes/Bactl's to <br /> prioritize further review Please notify Microbiology personnel immediately of bacti campEreceived <br /> 2 Do the number of bottles received agree with the COC9 o N/A <br /> 3 Were samples received intact? (i e no broken bottles, leaks etc ) o <br /> 4 Were sample custody seals intact 2N/ :: es No <br /> Sign and date the COC, obtain LEMS sample numbers, select methods/tests and print labels <br /> SaXnple Verification, Labeling and Distribution: <br /> 1 � Were all requested analyses understood and acceptable? o <br /> 2 Did bottle Iabels correspond with the client's ED's? Yes 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 of receipt? Yes No <br /> 5 Have rush or project due dates been checked and accepted? N/ Yes No <br /> Attach labels to the containers and include a copy of the COC for lab de <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 a temps) must be resolved <br /> 1 Person Contacted Phone Number <br /> Initiated By Date _ <br /> Problem (3-14996) <br /> • Resolution Ground zero Ana3Ysis <br /> STK0338056 <br /> SRP-12/18/2003-10:20:16 <br /> Attach label witli lab number heie <br />