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1 <br /> 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 <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/rushesBacti'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? fte <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 apies <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 atone 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'y No N/A <br /> 3 Were samples received intact? (i e no broken bottles, leaks etc ) es No <br />' 4 Were sample custody seals intact? � Yes No <br /> Sign and date the COC, obtain LINTS sample numbers, select methods/tests and print labels <br />' Sample Verification, Labeling and Distribution: <br /> I Were all requested analyses understood and acceptable? es No <br />' 2 Did bottle labels correspond with the client's ID's? No <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? No <br /> 5 Have rush or project due dates been checked and accepted? � Yes No r <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 Phone Number <br /> Initiated By Date <br /> Problem (2x552) 7�v <br /> Ground Zero - Stockton <br /> Resolution <br /> SP 0406528 <br /> 1 SH-06/28/2004-11.41 11 <br />