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FGL Environmental Doc ID- 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 many packages are received at one time check for tests/H T 's/nishes/Bacti'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 67s No N/A <br /> 4 Were samples received intact? (i a no broken bottles, Ieaks etc ) v No <br /> _x <br /> S Were sample custody seals intact /A' Yes No <br /> r <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as the sample <br /> Sample Receipt Review completed by(initials) <br /> Sample Receipt at SP: <br /> 1 Were samples received in a chilled condition? Temps / I I I <br /> Acceptable is above freezing to 6° C If many packages are received atone time check for tests/H T's/rushesBacti's to <br /> pnontize further review Please notify Microbiology personnel immediately of back sample ecei ed <br /> 2 Do the number of bottles received agree with the COC? No NIA <br /> 03 Were samples received intact? (i e no broken bottles, leaks etc ) No <br /> 4 Were sample custody seals intact? Iv'/ 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? es No <br /> 3 Were all bottles requiring sample preservation properly preserved? e No NIA FGL <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? N/ Yes No <br /> Attach labels to the containers and include a copy of the COC for lab deli , <br /> r <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 a temps) must be resolved <br /> 1 Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> 40 (3-1.4996) <br /> Resolution Ground Zero Analysis <br /> STK0431S83 <br /> SRP-03/19/2004-12.13 33 <br />