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OCT-01-2002 10 :29 AM L197u"�µ4k7A 0 r-. as <br /> k CrL l,a►vu'onutell tal 1)0C JU: 1,?1t11A,UU5.UUa <br /> ttcvistan Date: 3/8/01 rage: 1 of 1 <br /> Sant. Paula - Condition Upon Receipt (Attach to GOC) <br /> x'40 Sample Receipt: <br /> 1. Number of ice ch sts/packages received: <br /> Note as OTC if'recei ed over the counter unpackaged. <br /> 2. Were samples received in a chilled condition? Temps: ___,— <br /> Acceptable is above eczing to 6° C. Also acceptable is received oilice(RO1)for the same day of sampling or <br /> received at room temperature (Rill') if sampled Within one hour of receipt. Clicnt contact for temperature failures <br /> must be documented )elow. Tf many packaycs are received di one lilac check for tests/(-T.'l'.'s/rushes/13acti's to <br /> prioritize further revi w. Please notify Microbiology personnel imuncthatcly or!lactl sfu"ples received. <br /> 3. Do the number of bottles received agree with the COC? , `s; No N/A <br /> 4. Wcrc samples received intact? (i.e. no brokcat bottles, leaks etc.) ,� es ? No <br /> 5. Were sample cusi ody seals intact? ) Yes No <br /> Sign and date the COC obtain LIMS sample numbers, select methods/tests lid print. labels. <br /> 5arnple Verification, abelinb and Distribution: <br /> 1. Were all requested analyses understood and acceptable? es No <br /> 2. Did bottle labels orrc.spond with the client's ID's? No <br /> 3. Were all bottles acquiring sample preservation prohcrly preserved? Yes No C±t�55�FGL <br /> 4, Were all analyse within holding times at tine of receipt? No <br /> 5, Ilnve rush or pro ect due dates been checked and accepted? Yes No <br /> Arrach labels to the co stainers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Logit and Verification compleied by(initials): <br /> Discrepancy Documentation: <br /> Any items above which arc "No" or do riot meet specifications (i.e. 1,0111ps) must be resolved. <br /> 1. Person Contacted: —, Phone Numbcr:_ <br /> Initiated By _.�. ~.�. ._ __. . Date::Problem: <br /> Resolution: <br /> 2. Person Contacte 1:----._. __._ _-_ . Phone Number: __..-.—_---_— <br /> [nitiated By: Date: <br /> p1.OhlCCCI; <br /> Resolution: 3012628 <br /> Keystone Automotive Industries Inc. <br />