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FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> 4 Sample Receipt at STK: <br /> L 1. Number of ice chests/packages received: XeT/ <br /> 2. Were samples received in a chilled condition? Temps: I / 1 I <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROI)for the same day of sampling or <br /> a' 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 testslH.T.'slrushes/Bacti's to <br /> prioritize feather review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? M,, e <br /> No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as am les. <br /> Sample Receipt Review completed by(initials): <br /> j Sample Receipt at SP: <br /> .! 1. Were samples received in a chilled condition? Temps: I I I I <br /> Acceptable is above freezing to 6°C. if many packages are received at one time check for tests/H.T.'s/rushes/Bacti's to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? CYes No N/A <br /> 1 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ye� No <br /> 4. Were sample custody seals intact? Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> i 1. Were all requested analyses understood and acceptable? Y No <br /> 11 <br /> 2. Did bottle labels correspond with the client's ID's? (:Y:a No <br /> ! t 3. Were all bottles requiring sample preservation properly preserved? Yes No (�5A FGL <br /> 4. Were all analyses within holding times at time of receipt? s No <br /> 5. Have rush or project due dates been checked and accepted? N/ Yes No <br /> Attach labels to the containers and include a copy of the COC for lab delive <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: Uhnne Number: <br /> Initiated By: (3-9574) <br /> Problem: N$!1 44anderson & ASSOC ia es <br /> Resolution: STK /3 8150 7 <br /> `- <br /> 2,7T-09/05/2007-1 6:15:18 <br />