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FGL Environmental <br /> Revision Date: 10/23/07 Doc ID: F3REC005.004 <br /> 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 /> I 2. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. Also acceptable is received d on ice(ROI)for the same day of sampling or <br /> Ireceived 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? tths <br /> o N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) o <br /> 5. Were sample custody seals intact? es No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest s. <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 one time check for tests/H.T.'s/rushesBacti'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 N/A <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 4. Were sample custody seals intact? N/A 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 /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? s No <br /> 3. Were all bottles requiring sample preservation properly preserved? Ye No N/A FGL <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Were all analyses within holding times at time of receipt? s 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 delivery. <br /> Sample Receipt, Login and Verification completed by(initials): c_S <br /> Discrepancy Documentation: <br /> Any items above which are "No"or do not meet specifications (i.e. temps) must be resolved. <br /> I. Person Contacted: Phone Number <br /> Initiated By: i <br /> Problem: (3-1202") <br /> Resolution: <br /> LuhdorLf & Scalmaninl COnsult+n� <br /> STK0851907 <br /> 74:0� <br /> IV-11/26/2008-'0: <br />