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08-02-'12 11;10 FROM -SKS ENTERPRISES INC, 209-7593154 T-378 P019 F-358 FGL Environmental Doc ID: F3REC005.005 Revision Date: 2/13/09 Paget 1 of 1 Stockton - Condition Upon Receipt (Attach to COC) Sample Receipt at STK: / k received' ! . Number of ice chests pac ages ?" Were samples received in a chilled condition? Temps: Acceptable is above freezing to 6° C. Also acceptable is received on ice (1101) for the same day of sampling or received at roost temperature (P.RT) if sampled within one hour of rcccipt. Client contact for temperature failures must be documented below. if many packages are received at one time check for tests/H.T.'s/rushes/Bacti's to prioritize further review. Please notify Microbiology personnel immediately of bFC5 s received.. 3. Do the number of bottles received agree with the COC? No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No 5. VOAs checked for I{eadspace? No 6. Were sample custody seals intact? Yes No Sign and date the COC. place in a ziplock and put in the same ice chest as the sa Sample Receipt Review completed by (initials): Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps: / / / / Acceptable is above freezing to 6° C. If tetany packages arc received at one time check for tests/H.T.'s/rushes/Bacti's to prioritize further review. Please notify Microbiology ohne) irnmedia` elf of bacti samples received. 2 Do the numN of bottles received agree with the COC? es No N/A 3. Were samples r r^eived intact? (i.e. no broken bottles, leaks etc.) Yes No 4. Were sample custody�seals intact? Yes No N/A Sign and date the COC. obtaiTkIIMS sample numbers, select me o/t sts and print labels. Sample Verification, Labelinkw,d Distribution: 1. Were all requested analyses"unlL�tood and accept le? Yes No 2. Did bottle labels correspond with the cli s lb's? Yes No 3. Were all bottles requiring sampt"feservation p erly preserved? Yes No N/A FGL 4. VOAs checked for Fleadsp e? Yes No N/A 5. Were all analyses wit n holding times at time of receipt? Yes No 6. Have rush or prof ct due dates been checked and accepted? 'Yes No N//A Attach labels to the cont"Ainers and include a copy of the COC for lab delivery. Sample Receipt, Login and Verification completed by (initials): Discrepancy Documentation: Any items above %vbieb are "No" or do not meet specifications (i.e. temps) must be resolved. I. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: Received Time Aug. 2. 2012 11:08AM No,0200 Attach label with lab number here