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Revision Date 10/20/00 1'a�e 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COQ) <br /> S ample Receipt at STK ; <br /> 1 Number of ice chests/packages received- <br /> 2 Were samples received in a chilled condition's Temps <br /> Acceptable is above freezing to b' C Note as AOI (arrived on ice) if chillif c}ulhrig was begun for samples received on <br /> same day of sampling Samples may be received without cooling if sampled within one hour of receipt <br /> 3 Do the number of bottles received agree with the COC? Yes No N/A <br /> a <br /> 4 Were samples Teceived intact? (i e no broken bottles, leaks etc ) Yes No <br /> 5 Were sample custody seals intact? N/ Yes No <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 <br /> Acceptabte is above freeztn�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 nurribei of bottles received agree with the COC? Yes 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? N/A Yes No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and pnnt labels <br /> Sample Verification, Labeling and Distribution: <br /> 1 Were all requested analyses understood and accepjable? Ye r No <br /> 2 Did bottle labels correspond with the client's ID's? Yes No <br /> 3 Were all bottles requiring sample preservation properly preserved? Yes No N/ FGL <br /> 4 Were all analyses within holding times at time of receipt? es 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 deliv <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 /> I Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> Resolution (3-14996) <br /> Ground Zero Analysis <br /> r <br /> 5TK0335847 <br /> SRP-09/25/2003;01.19 PM <br /> YYIII( IdU tiunlber here <br />