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FGL Envirani mental Doe m:3DO900002-SC P_12-LDDC <br /> Revision Date: 10109/14 Page 1 of 1 <br /> Inter- tory Condition Upon Receipt (Attach to CO 4P-V9/V <br /> Sample Rece pt at: ST CC CH VI <br /> 1. Numbe of ice chests/packages received: Shipping tracking N <br /> 2. Were s plea received in a chilled condition? Temps:�/_/ <br /> Surface v ater SWTR bact samples: A sample that has a temperature upon receipt of>10-C,wl ether iced or not, <br /> should be flaggc d unless the time since sample collection has been less than two hours. ��,,rr��,, <br /> 3. Do the tunber of bottles received agree with the COC? No N/A <br /> 4. Were at topics received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. VOAs hecked for Headspace? Ye No N/A <br /> 6. Were at ple custody seals intact? Yes No <br /> 7. If requi , was sample split for pH analysis? Y No N/ <br /> 8. Were a analyses within holding times at time of receipt? No <br /> 9. Verify ple date,time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put nt¢e ame ice chest as the sample . <br /> Sample Rece In Review completed by (initials): I <br /> Sample Rmg ipt at SP: <br /> I. Were at ples received in a chilled condition? Temps: <br /> Acceptat Ie is above freezing to 60 C. If many packages are received at one time check for tesus/H.T.' rushes/ <br /> 2. Shippir g tracking numbers: �Ol ysleU 6 <br /> 3. Do the iumber of bottles received agree with the COC? Nc N/A <br /> 4. Were si imples received intact?(i.e. no broken bottles, leaks etc.) e N <br /> S. Were simple custody seals intact? Yes N <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 a 1 requested analyses understood and acceptable? es N <br /> 2. Did bo le labels correspond with the client's ID's? s N <br /> 3. Were all bottles requiring sample preservation properly preserved? es N N/A FGL <br /> IE.,Han:011&G,.s VOA.d CrVIv,rrredio labl <br /> 4. V OAs hecked for Headspace? N N/A <br /> 5. Have in ish or project due dates been checked and accepted? Ye Niqd <br /> 6. Were all analyses within holding times at time of receipt? N <br /> Attach labeh to the containers and include a copy of the COC for lab delivery. <br /> Sample Recc ipt, Login and Verification completed by(initials):—,.� <br /> Discrepanc3 Documentation: <br /> Any items at ove which are"No"or do not meet specifications(i.e. temps) must be rnuilved. <br /> 1. Person Contacted: Phone Number <br /> — <br /> Initiated By: Date: <br /> Proble : <br /> Resolution: (3-16416) <br /> 2. Person Contacted: pmerican Biodiesel Inc, IDS community F <br /> Initiat By: <br /> Proble : STK203 814 <br /> Resolution: <br /> CfC-02/28/202 -15:35:2 <br /> sere <br /> (Please use the back of this sheet for additional comr _ —- <br /> contacts) <br />