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Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L"tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: kaK CC CH VI <br /> 1. Number of ice chests/packages received: Shipping # <br /> 2. Were samples received in a chilled condition? Temps:/`e / / / <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >10'C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? Mes <br /> No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) o <br /> 5. VOAs checked for Headspace? No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required,was sample split for pH analysis? Yes. No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name k,Yes No <br /> Sign and date the COC,place in a ziplock and put in a ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to ON C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking>T eZ2� <br /> �-4 )�5 <br /> ) SIIY/J� D 3. o the n ber of bottles agree with the COC? ts No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No <br /> S5. Were sample custody seals intact? Yes No T/ <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? Ve No <br /> 3. Were all bottles requiring sample preservation properly preserved? No FGL <br /> [Exception:Oil&Grease,VOA and CrV1 verified in lab[ <br /> 4. VOAs checked for Headspace? Yes No <br /> l� )� <br /> 5. Have rush or project due dates been checked and accepted? No N/A <br /> 6. Were all analyses within holding times at time of receipt? No <br /> Attach labels to the containers and include a copy of the COC for lab deli ery. <br /> Sample Receipt, Login and Verification completed by(initials): <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 /> 2. Person Contacted: (3-16608) <br /> Initiated By: <br /> Problem: Live Oak Geo �tVlroTl111ental <br /> . Resolution: STK1832058 <br /> (Please use the back of this sheet for additional c ApB-02/13/2018-16:10:07 er here <br /> contacts) — -- <br />