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F'GL Environmental Doc ID•• F3REC005.005 <br /> Revision Date: 2/13/09 Page: 1of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> I. Number of ice chests/packages received: / <br /> 2. Were samples received in :t chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(R(5I) 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 tests/H.T.'s/nishes.Bact i's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bWe's <br /> s received.. <br /> 3. Do the number of bottles received agree with the COC? o N/A <br /> 4. Were samples received intact?(i.e. no broken bottles.leaks etc.) o5. VOAs checked for I leadspace'? No <br /> 6. Were sample custody seals intact? Yes No NI-t <br /> Sign and date the COC. place in a ziplock and pttt in the same ice chest as the sat les. <br /> Sample Reccipt Review completed by(initials): <br /> Sample Receipt at SP: r n° <br /> 1. Were samples received in a chilled condition'? T emps:U <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for <br /> tests/1I.T.'s/rushes/Bacti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? No N/A <br /> 3. Were samples received intact?(i.e. no broken bottles,leaks etc.) No <br /> 4. Were sample custody seals intact'? Yes No NIA <br /> Sign and date the COC. obtain LIMS sample numbers, select methods/tests and print abets. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Yes No <br /> 2. Did bottle labels correspond with the client's fD's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4. VOAs checked for hleadspace? No <br /> 5. Were all analyses within holding times at time of receipt'? No <br /> 6. Have rush or project due dates been checked and accepted? Yes No !!A <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <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 /> RmIulivn; (3-11544 <br /> Husco Family alive Environmental <br /> STK1336300 <br /> NMB-06/28/2013-10:32:59 <br />