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FGL Environmental Doc ID: <br />F3EC005.002 <br />Revision ate: 01/20/04 Page: 1 of 1 <br />Sample Receipt at STK: <br />1. Number of ice chests/packages received: <br />2. Were samples received in a chilled condition? Temps: <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 tests/H.T.'s/rushesBacti's to <br />prioritize further review. Please notify Microbiology personnel immediately of bacti samples received.. <br />3. Do the number of bottles received agree with the COC? <br />es <br />No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)FN <br />es <br />No <br />5. Were sample custody seals intact? <br />/A—)Yes <br />No <br />Sign and date the COC, place in a ziplock and put in the same ice chest as plea. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: / / / / <br />Acceptable is above freezing to 6° C. If many packages are received at one time check for tests/H.T.'s/rushesBacti's to <br />prioritize further review. Please notify Microbiology personnel 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.) Cs No <br />4. Were sample custody seals intact? N A 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 />1. <br />Were all requested analyses understood and acceptable? <br />No <br />2. <br />Did bottle labels correspond with the client's ID's? <br />Yes <br />No <br />3. <br />Were all bottles requiring sample preservation properly preserved? Yes <br />No` FGL <br />4. <br />Were all analyses within holding times at time of receipt? <br />No <br />5. <br />Have rush or project due dates been checked and accepted?N/ <br />Yes No <br />Attach labels to the containers and include a copy of the COC for lab delive <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: <br />Problem: <br />Resolution: <br />Date: <br />