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1FGL Environmental <br />Doc 1t7: <br />k'3REC005.002 Page: I of I <br />Revision Date: 01/20/04 <br />Stockton - Condition Upon Receipt (Attach to COC) <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 (RFT) if sampled within one hour of receipt. Client contact for temperature failures <br />must be documented below. If many packages are received netime cheratcly of r Ws samples rus es/Bacti's to <br />prioritize further review. Please notify Microbiology personnel <br />3 Do the number of bottles received agree with the COC? es No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) I Yes , No <br />5. Were sample custody seals intact? N„„/.A Yes No <br />Sign and date the COC, place in a ziplock and put in the same ice chest as ples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP:/_a <br />1. Were samples received in a chilled condition? Temps:.- / _ / <br />Acceptable is above freezing to 6° C. If many packages are received atone time check for tests/H.T.'s/rushes/Bacti'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? CNo N/A <br />3. Were samples received intact? (i.e. no broken bottles, leaks etc.) (..'�.2s No <br />4. Were sample custody seals intact? (�A Yes No <br />Sign and date the COC, obtain LINES sample numbers, select methods/tests and print labels. <br />Sample Verification, Labeling and Distribution: <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 sample preservation properly preserved? Yes No _C*, FGL <br />4. Were all analyses within holding times at time of receipt? C No <br />5. Have rush or project due dates been checked and accepted? SkYes No <br />Attach labels to the containers and include a copy of the COC for lab deliver <br />Sample Receipt, Login and Verification completed by (initials): p? <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 />Ed Wd9tb : TO 200E OT 'daS 9T T628660E 'ON Xtid 9N I AOmjiNOd I d WOJd <br />