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Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-Lotory Condition Upon Receipt(Attach to COC) // .A?78 r <br /> • Sample Receipt at: STK CC CH VI <br /> 1. Number of ice ch ackages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps:�/ / / / <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? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. VOAs checked for Headspace? *YeNo N/A <br /> 6. Were sample custody seals intact? Yes No coz <br /> 7. If required, was sample split for pH analysis? Yes. No N/ <br /> 8. Were all analyses within holding times at time of receipt? Y No <br /> 9. Verify sample date, time and sampler nam es No <br /> Sign and date the COC, place in a ziplock and put in tJt same ice chest as pies. <br /> Sample Receipt Review completed by(initials): / <br /> Sample Receipt at SP: �n / <br /> 1. Were samples received in a chilled condition? Temps: 4/ / 0/ (.n / <br /> Acceptable is above freezing to 6.v C. If many packages are received at one time check tests/H.T.'shushes/ <br /> 2. Shiing tracking numbers: ��r „ (�/��m3nily <br /> IluenoumlMceived�3+ t{�� �J l}'� /J 3. agree with the COC? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> • 5. Were sample custody seals intact? es No N/A <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? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No N/ FGL <br /> [Ezmptton:Oil&Grease,VOA and CrVI verified In lab] <br /> 4. VOAs checked for Headspace? (� No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No <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 for lab d e <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 /> I. 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 EhViroMental <br /> Resolution: STK1638781 <br /> (Please use the back of this sheet for additional corn, SRP-07/18/2016-15:45:51 1ere <br /> contactO <br />