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05/09/06 THU 15:40 FAX 011 <br /> FGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> r <br /> Stockton - ondition Upon Receipt(Attach to COC) <br /> .. Sample Receipt at STK: <br /> 1. Number of ice chests/packag'es received: <br /> 2. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(R01)for the same day of sampling or <br /> received at room temperature(RR1)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 tests/H.T.'s/mshes/Bacti's to <br /> .r prioritize further review. Please notify Microbiology personnel immediately of bkesNo <br /> ed- <br /> 3. Do the number of bottles received agree with the COC? N/A <br /> ` 4. Were samples received intact?(i.e.no broken bottles,leaks etc.)5. Were sample custody seals intact? No <br /> Sign and date the COC,place in a pplock and put in the same ice chest a <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 6°L If many packages are received at one time check for tnW14.T.'shu9hes1B1cti's to <br /> prioritize further tcvicw. Please notify Microbiology personnel immediately of bacti samples received <br /> L 2. Do the number of bottles received agree with the COC? es No N/A <br /> I <br /> 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) No <br /> L 4. Were sample custody seals intact? N/� Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> 6. Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? (as,-,, No <br /> _ 2. Did bottle labels correspond with the client's ID's? (e No <br /> 3. Were all bottles requiring sample preservation properly preserved? eYV§-) No N/A FGL <br /> _ 4. Were all analyses within holding times at time of receipt? (!p No <br /> 5. Have rush or project due datei s been checked and accepted? Yes No <br /> Attach labels to the containers and i include a copy of the COC for lab delivery. <br /> � / <br /> Sample Receipt,Login and Verification completed by(initials): <br /> L 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 /> ------- . <br /> Problem: _---- --- <br /> —-- ~—` (3_9578) <br /> Resolution: ^ Neil Anderson & Associates <br /> STK0631829 <br /> V-03/02/2006-08-.53-50 <br /> i <br />