Laserfiche WebLink
FGL Environmental Doc ID: 3D0900002_7_12-3.DOC <br />Revision Date: 10/09/14 Page 1 of 1 <br />Inter- tory Condition Upon Receipt (Attach to CO <br />Sample Receipt at: STK CC CH VI <br />1. Number of ice chests packages received: / Shipping tracking # <br />2. Were samples received in a chilled condition? Temps:�lz' / <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I0' C, w ether iced or not, <br />should be flagged unless the time since sample collection has been less than two hours. <br />3. <br />Do the number of bottles received agree with the COC? <br />No <br />N/A <br />4. <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />Yes No <br />N/A FGL <br />5. <br />VOAs checked for Headspace? <br />Yes No <br />N/ <br />6. <br />Were sample custody seals intact? <br />Yes No <br />7. <br />If required, was sample split for pH analysis? <br />Yes No <br />/A <br />8. <br />Were all analyses within holding times at time of receipt?No <br />Any items above which are "No" or do not meet specifications (i.e. temps) must be resolved. <br />9. <br />Verify sample date, time and sampler name <br />No <br />Mples <br />Sign and date the COC, place in a ziplock and put int ame ice chest <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />4—/—/—/ <br />1. <br />Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 6E C. If many packages are received at one time check for tests/H.T.'s <br />rushes/ <br />2. <br />Shipping tracking numbers: <br />15�S?615l 3 <br />3. <br />Do the number of bottles received agree with the COC? <br />No <br />N/A <br />4. <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />es No <br />5. <br />Were sample custody seals intact? <br />Yes No <br />/A <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print l#bels. <br />Sample Verification, Labeling and Distribution: <br />1. Were all requested analyses understood and acceptable? No <br />2. Did bottle labels correspond with the client's ID's? a No <br />3. Were all bottles requiring sample preservation properly preserved? e No <br />N/A FGL <br />(Exception: Oil & Grease, VOA and CM verified in labl <br />4. VOAs checked for Headspace? Yes No <br /><32A <br />5. Have rush or project due dates been checked and accepted? Yes No <br />(ISA <br />6. Were all analyses within holding times at time of receipt? es No <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 />2. <br />Problem: <br />Resolution: <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional-, <br />contacts) <br />(3018181) <br />Metal Finishing Solutions, Inc <br />STU152815 <br />apb 091101202116:36:32 <br />Ill <br />STK2152 <br />l�llQl9ll1111111111�1 <br />STK2152813 <br />re <br />