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FGL Environmental Doc ID:3DO900002_SgP_12-31.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-LaWatory Condition Upon Receipt (Attach to COC) /�5757.3 <br /> Sample Receipt at: K CC CH VI <br /> 1. Number of ice cher packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps-AF <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. j <br /> 3. Do the number of bottles received agree with the COC? Noj N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No.: <br /> 5. VOAs checked for Headspace? es Nol, <br /> 6. Were sample custody seals intact? Yes No (32 <br /> 7. If required, was sample split for pH analysis? Y No / <br /> 8. Were all analyses within holding times at time of receipt? Nod <br /> 9. Verify sample date, time and sampler name es No <br /> Sign and date the COC,place in a ziplock and put ' s e ice chest asMe-sample$. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: q <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to Ok C. If many packages are received at one time check for tes T.:,s/rush�es^/ <br /> 2. Shipping tracking numbers: OcO V liW b1-1Q(bJ u7D 5V <br /> 3. Do the number of bottles received agree with the COC? No I N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,It etc.) Nol <br /> 5. Were sample custody seals intact? ieps NoN/A <br /> Sign and date the COC,obtain LIMS sample numbers, select methods/tests and print abe <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? No <br /> 3. Were all bottles requiring sample preservation properly preserved? NoN/A FGL <br /> !Exception:011&Grease,VOA and CrVI verified in lab! <br /> 4. VOAs checked for Headspace? es No N A <br /> 5. Have rush or project due dates been checked and accepted? No N/ <br /> 6. Were all analyses within holding times at time of receipt? es No <br /> Attach labels to the containers and include a copy of the COC or 1 b eli <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 re iolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: (3-j(5608) <br /> Initiated By: Dive Oak Geoff &vironmental <br /> Problem: <br /> Resolution: STK 153 9 4 7 3 <br /> (Please use the back of this sheet for additional comments c NMP-08/26/2015-10:42:40 <br /> contacts) <br />