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Ad1h AftIMF <br /> FGL Environmental Doc ID: BREC005.005 <br /> Revision Date: 2/13/09 Page: 1 of 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 a chilled condition? Temps: -Ice <br /> /_/_ <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROp for the same day of sampling or <br /> received at room temperance(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/rushes,13acti's to <br /> prioritize further review. Please notify Microbiology personnel immediately ofbacti�]s�ggtples received.. <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact?(i.e_no broken battles. leaks etc.) Yes No <br /> 5. VOAs checked for I leadspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> Sign and date the COC. place in a ziplock and put in the same ice chest as th at le <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> L Were samples received in a chilled condition') Temps: 40"'1_1_/_/_ <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for <br /> tests/1-I:f.'s/rushes/13acti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacti samples received. <br /> ?. 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? No N/A <br /> Sign and date the COC.obtain LIMS sample numbers,select mcthods/lests and ilabels. <br /> Sample Verification, Labeling and Distribution: <br /> I. Were all requested analyses understood and acceptable? 5'es No <br /> 2. Did bolt le labels correspond with the client's ID's? Ye No <br /> 3. Were all bottles requiring sample preservation property preserved? Y No N/A PGL <br /> 4. VOAs checked for licadspace? Yes No <br /> 5. Were all analyses within holding times at time of receipt? 5�—'-No <br /> 6. Have rush or project due dates been checked and accepted? Yes No <br /> Attach labels to the containers and include a copy of the COC for tab delivery. , <br /> Sample Receipt, Login and Verification completed by(initials): ter/ <br /> Discrepancy Documentation: <br /> Any items above which are"No"or do not na:et specifications(i.e.temps)must be resolved. <br /> I. Person Contacted:_ Phone Number: <br /> Initiated By Date: <br /> Problem: <br /> Resolution: i 3-i655i 1 <br /> P}:Tr <br /> toa��.Ye <br /> STK1032437 <br /> IV-03/19/2010-10:22:36 <br />