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FGL Environmental Doc ID. F3REC005.002 <br /> Revision Date 10/11/02 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 I I 1 I <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 withm 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 samples received <br /> 3 Do the number of bottles received agree with the COC9 Yes No NIA <br />' 4 Were samples received intact? (i a no broken bottles, leaks etc ) S5 . No <br /> 5 Were sample custody seals u&act9 Yes No <br />' r <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as samples <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/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 No N/A <br /> 3 Were samples received intact? (i a no broken bottles, leaks etc ) No <br /> 4 Were sample custody seals intact 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? No <br /> 2 Did bottle labels correspond with the client's ID's' <br />' 3 Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> 4 Were all analyses within holding times at time of receipt? 6,ZNo <br />' 5 Have rush or project due dates been checked and accepted? �i'es 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 /> �y r <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 /> — Al1�r 1, 1_,}, ,I tcr,i}, fns, r+,in,l,P, Cl E•LE- <br />