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07/07/06 FRI 19:02 FAX 006 <br /> FGL Environmental Doe ID: `. <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton- Condition Upon Receipt(Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages 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(ROI)for the same day of sampling or <br /> received at room temperature(RRT)if sampled within one hour of receipt. Client contact for temperature failures <br /> must be documented below. If[natty packages are received at one time check for tests/H.T.'s/tushesBaeti'g to <br /> prioritize further review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received 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? N/A Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: el- <br /> 1 Were samples received in a chilled condition? Temps: /—/—/—/— <br /> Acceptable, <br /> —/ /—/—Acceptable is above lieeaing to VC. if many packages are received at one dine check for resWH.T.'s/ruahes/ftacti'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? No N/A <br /> 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) ryes <br /> o <br /> 4. Were sample custody seals intact? _ No <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? Ye No <br /> 2. Did bottle labels correspond with the client's ID's? Yes No <br /> 3. Were all bottles requiring sample preservation properly presery No N/A FOL <br /> 4. Were all analyses within holding times at time of receipt? No <br /> 5. Have rush or project due dates been checked and accepted? e No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <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: Phone Number: <br /> Initiated By: —_-- Date <br /> Problem, (3-9574) <br /> Resolution: Neil Anderson & Associates <br /> STK0635396 <br /> IV-06/30/2006-15:35:19 <br />