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Doe TD: F3RE0001;.O():3 Revision Date: !0/23/0-, %00 kad Page: 1 of I T-TI3011 Receipt (,4.ttach to C-OC) S2 MOle Rxceipr at S 11K: Number of ice chests/packages received: Were samples received in a chilled condition? Temps: Acceptable is above freezing to 6'C. Also acceptable is received on ice(ROI)for the same day of sampling or received at room temperature(RRT) if sampled Mthin one hour of receipt. Client contact for temperature failures must be documented below. if many packages are received at one time check for tests4f.T.'s/rushes/BacWs to Prioritize further review. Please notify Microbiology personnel inunediately of bacii samples received., 3. Do the number of bottles received agree with the COC? Yes No N/A 4. Were,samples received intact? (Le. no broken bottles, leaks etc.) YeY No — 5. Were sample custody seals intact? /A Yes No Sign and date the COC, place in a ziplock and put in the same ice chest as I. e samples. Sample Receipt Review completed by(initials': r, Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps, Acceptable is above freezing to 6'C. If many packages are received at one time check for tests1H.T.'Orushes/Bact"s to prioritize further review. Please notify Microbiology personnel immediately of bacti salnplpq received. 2. Do the number of bottles received agree with the COC? ' No N/A I Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes No N/A 4. Were sample custody seals intact? Yes No Sign and date the COC, obtain LIMS sample numbers, select inethods/tests and print labels. SRmple Verification, Labeling and Distribuflori: I- Were all requested analyses understood and acceptable? No Yes 2. Did bottle labels correspond with the client's ID's? No 3. Were all bottles requiring sample preservation properly preserved? Yes No(O'O�N/A FGL 4. VOAs checked for HeadspaGe? Yes No N/A 5. Were all analyses within holding times at time of receipt? es No 6. Have rush or project due dates been checked and accepted? AIA No Attach labels to the containers and include a copy of the COC for lab deliv Sample Receipt, Login and Verification completed by(initials): Discrepancy Documentation'. Aroy items above which are "NO- of do not rnecl SpeCifiCallol-jS (),e. temps) DAIst be resolved. I ' Person Ccmiacle& Phone Number____-_ 111iliated. Bv: -------- -- Piobltm: Resoluiiow- lei' 1 Andersch STKO7151908 IV-1-2/13/2007-13:33:09