Laserfiche WebLink
0 Su nSta r' ,s, <br /> 20. <br /> Laboratories <br /> SAMPLE RECEIVING REVIEW SHEET <br /> Batch/Work Order#: <br /> Client Name: / Project: <br /> Delivered by: ❑Client ❑ SunStar Courier ©GSO ❑FedEx ❑Other <br /> If Courier,Received by: Date/Time Courier <br /> Received: <br /> Lab Received by: Date/Time Lab <br /> &.A�3 Received: qtr o,na <br /> Total number of coolers received: <br /> Temperature: Cooler#1 s 3 °C+/-the CF(-0.2°C) = 5 i °C corrected temperature <br /> Temperature: Cooler#2 'C+/-the CF(-0.2°C) = °C corrected temperature <br /> Temperature: Cooler#3 °C+/-the CF(-0.2°C) = °C corrected temperature <br /> Temperature criteria=:5 VC Within criteria? QYes [—]No <br /> no frozen containers <br /> If NO: <br /> Samples received on ice? ❑Yes [—]No <br /> Complete Non-Conformance Sheet <br /> if on ice,samples received same day ❑Yes 4 Acceptable ❑No 4 <br /> collected? Complete Non-Conformance Sheet <br /> Custody seals intact on cooler/sample ©Yes ❑No* ❑N/A <br /> Sample containers intact ( Yes ❑No* <br /> Sample labels match Chain of Custody IDs ®Yes ❑No* <br /> Total number of containers received match COC []Yes ❑No* <br /> Proper containers received for analyses requested on COC ®Yes ❑No* <br /> Proper preservative indicated on COC/containers for analyses requested ❑Yes []No* [�]N/A <br /> Complete shipment received in good condition with correct temperatures, <br /> containers,labels,volumes preservatives and within method specified ® Yes []No* <br /> holding times <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review-Initials and date: <br /> Comments: <br /> Page 1 of <br />