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FGL Environmental <br /> F3REC005.002- Doc ID: <br /> Revision Date: 01/20/04 <br /> Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> I. 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 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 sapjRles received.. <br /> 3. Do the number of bottles received agree with the COC? <br /> No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) Y No <br /> 5. Were sample custody seals intact? <br /> N/A" <br /> PYes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the sa <br /> Sample Receipt Review completed by(initials): _� <br /> Sample Receipt at SP: <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for tests/H.T.'s/rushes/B cti'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? <br /> e No N/A <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) e / No <br /> 4. Were sample custody seals intact? <br /> _ � 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. Were all requested analyses understood and acceptable? ieoNo <br /> 2. Did bottle labels correspond with the client's ID's? <br /> es . No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4. Were all analyses within holding times at time of receipt? e No <br /> 5. Have rush or project due dates been checked and accepted? 4T Yes 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: <br /> Phone Number: <br /> Initiated By: <br /> Problem: (3---- 5835) <br /> M D <br /> -investments <br /> Resolution: TK <br /> 0632280 <br /> -W-03/ 7/2006-09:07:17 <br />