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FGL Environmental Doc ID: F2REC005.008 <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 chests/packages received: <br />Note as OTC if received over the counter unpackaged. <br />2. Were samples received in a chilled condition? Temps(-() <br />. <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 te' ts/H.T.'s/rushes/Bacti's to <br />prioritize further review. Please notify Microbiology personnel immediately of h ti samples received. <br />3. Do the number of bottles received agree with the COC?gN/ <br />No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />5. Were sample custody seals intact? 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? t,x' <br />No2. Did bottle labels correspond with the client's ID's? No3. Were all bottles requiring sample preservation properly preservedN N/ FGL <br />4. Were all analyses within holding times at time of receipt? Y No <br />5. Have rush or project due dates been checked and accepted? / Yes No <br />Attach labels to the containers and include a copy of the COC for lab d <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 resolved. <br />1. Person Contacted: Phone Number: <br />Initiated By: Date: <br />Problem: <br />2 <br />Resolution: <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />Phone Number: <br />Date: <br />(3-15039) <br />Mountain Valley Express <br />STK®333648 <br />LMC -06/23/2003:09:07 PM <br />mber here <br />