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f _ <br /> FGL Environmental Doc ID: F3RE0005.004 <br /> Revision Date: 10/23/07 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 many packages are received at one time check for tests/H.T.'s/tushesBacti s 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? *N/ <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 the les. <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°C. if many packages are received at d6 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? es � No NIA <br /> 3. Were samples received intact? (i.e.no broken bottles, leaks etc.) - No <br /> 4. Were sample custody seals intact? /A Yes No <br /> Sign and date the COC,obtain LIMS sample numbers, select methods/tes nd 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? §Ye <br /> No <br /> 3. Were all bottles requiring sample preservation properly preservedNo N/A FGL <br /> FGL <br /> 4. VOAs checked for Headspace? Yes No CSA/ <br /> 5. Were all analyses within holding times at time of receipt? Yes No <br /> 6. Have rush or project due dates been checked and accepted? Yes No <br /> Attach labels to the containers and include a copy of the COC for lab deli <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: <br /> Resolution: <br /> Attach label�wit lab number here <br />