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FGL Environmental Doc ID: F3RFC005.005 <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 /> ?. Were samples received in a chilled condition? Temps: P4FP <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(R(5I) 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 re%ice'. Please notify Microbiology personnel immediately of bac uplu 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? es No <br /> 6. Were sample custody seals intact'? Yes No N/A <br /> Sign and date the COC. place in a ziplock and put in the same ice chest as the sal les. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SI': <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 <br /> iesis:'IFF.'s/rushesBacti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacii samples received. <br /> 3 Do the number of bottles received agree with the COC? No NIA <br /> 3 Were samples received intact?(i.e. no broken bottles, leaks etc.) o <br /> 4. Were sample custody seals intact? es No N/A <br /> Sign and date the COC. obtain LIMS sample numbers, select methods/tcsts and print labels. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Y' No <br /> 2. Did boulc labels correspond with the clients ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? s No N/A FGL <br /> 4. VOAs checked for I leadspace? Yes No N/A <br /> 5. Were all analyses within holding times at time of receipt? Yes No <br /> 6. Have rush or project due dates been checked and accepted? Yes No N//A <br /> Attach labels to the containers and include a copy of the COC for lab dethe <br /> Sample Receipt, Login and Verification completed by(initials): <br /> Discrepancy Documen(ation: <br /> Any items above which are"No"or do not meet specifications I,i.e. temps)must be resolved. <br /> I. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> Luhdorff & oraimanini wriSM ItIrl <br /> STK12. 50809 <br /> tnn._11/2111210112-12:L_:19 <br />