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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 /> I Number of ice chests/packages received <br /> 2 Were samples received in a chilled condition? Temps 1 I 1 I <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 bacti samples received <br /> 3 Do the number of bottles received agree with the COC? es No NIA <br /> 4 Were samples received intact? (i e no broken bottles, leaks etc ) es 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 completed by (initials) _- <br /> Sample Receipt at SP <br /> 1 Were samples received in a chilled condition? Temps I I 1 I <br /> Acceptable is above freezing to 6° C If rrany 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 of bacti samples received <br /> 2 Do the number of bottles received agree with the COC? 0 Tes <br /> No NIA <br /> 3 Were samples received intact? (I e no broken bottles, leaks etc ) es No <br /> 4 Were sample custody seals intact? LKI 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? es No <br /> 2 Did bottle labels correspond with the client's ID's? es No <br /> 3 Were all bottles requiring sample preservation properly preserved? Yes No < i gl FGL <br /> 4 Were all analyses within holding times at time of receipt? No <br /> 5 Have rush or project due dates been checked and accepted? NIA Yes No r <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 e temps) must be resoled <br /> 1 Person Contacted Phone Number <br /> Initiated By (42—� <br /> Problem Ground Zero - Stockton <br /> Resolution SP 0406523 <br /> SB--06/28/2004-11 41 11 <br />