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• F'GL Environmental Doc ID: F2REC005 009 <br /> Revision Date: 4/07/04 Page- 1 of 1 <br /> Santa Paula - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt: <br /> 1 Number of ice chests/packages received <br /> Note as OTC if received over the counter unpackaged <br /> 2 Were samples received in a chilled condition? Temps I 1 I 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(ART) 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/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 COC? No N/A <br /> 4 Were samples received intact? () a no broken bottles, leaks etc ) Y No <br /> 5 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? Ye No <br /> 3 Were all bottles requiring sample preservation properly preserved9 Yes — o 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? s No <br /> Attach labels to the containers and include a copy of the COC for lab <br /> Sample Receipt, Login and Venfication 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 /> I Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> Resolution <br /> 2 Person Contacted Phone Number <br /> Initiated By Date <br /> Problem <br /> Resolution <br /> Reserved Labels <br /> STK0437512 <br /> SRP-1.0/26/2004-11:35 24 <br /> er here <br />