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6-11-2003 12:38PM FPAW CITY OF STOCKTON 20993774 1 4P,14 <br />0 <br />t� t><L L+ 31iVL[ bit ptal Doc ID: F2REC005.008 <br />Revision Date: 3/8/01M1 Page: X 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 />Acceptable is above freezing to G° C. Also acceptable is received on icc. (ROI) for the same day of sampling or <br />received at room temperature (RR'I) 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 cbeck for tests/H.T.'s/rushes/Baeti''s to <br />prioritize further review. Please notify Microbiology personnel immediately of baeti sarnplcs 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 Distributioxv <br />1. . Were all requested analyses understood and acceptable? es No <br />2. Did bottle labels correspond with the client's ID's?Yes No <br />3: Were all bottles requiring saample preservation properly preserved? Yes No /A i"GL <br />4. Were all analyses within holding times at time of receipt? No <br />S. Have rush or project due dates been checked and accepted? N/A Yes No <br />Attach labels to the containers and include a copy of the COC for lab d.elive <br />�r <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 />Resolution: <br />2. Person Contacted: <br />Initiated By:, <br />Problem: <br />Resolution: <br />Phone Number: <br />Date: <br />Clty of Stctor�i0114Xmic <br />�f <br />pa.I z'v'1 ce Cl:.r <br />S3 31616 <br />