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FGL Environmental Doc 1D: F2RECOOS.UU8 <br /> Revision Date: 3/8/01 Page: 1 of 1 <br /> Santa Paula - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt: <br /> 1. Number of ice chest /packages received: <br /> Note as OTC if received over the counter unpackaged. <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(RRT) if sampled within one hour of receipt. Client contact for temperature failures <br /> must be documented bel w. 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 invnediately of bacti samples received. <br /> 3. Do the number of b ttles received agree with the COC? es) No N/A <br /> 4. Were samples recei ed intact? (i.e. no broken bottles, leaks etc.) es No <br /> 5. Were sample custody seals intact? Yes No <br /> 7 select methods/test print labels. <br /> Sten and date the COC, obtain L1MS sample numbers, sele n <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? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> 4. Were all analyses wi hin holding times at time of receipt? e No <br /> 5. Have rush or project due dates been checked and accepted? /?51 Yes No <br /> Attach labels to the contai iers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documents ion: <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 /> Problem: <br /> Resolution: <br /> 3012628 <br /> Keystone Automotive Industries Inc. <br /> STK233284 <br /> Temp: na <br />