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08/30/2006 14:00 FAX 8 552547-"' FGL ENVIRONMENTAL 012/012 <br /> )FGL Environmenta Doc ll): <br /> F3REC005,002 <br /> Rpvivion nate: 01/2 104 Page: 1 of 1 <br /> tockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at TK: <br /> 1. Number of ice hests/packages received: <br /> 2. Were samples eceived in a chilled condition? Temps: <br /> Acceptable is abo a freezing to 6°C. Also acceptable is received on ice(ROI)for the same day of sampling or <br /> received at room t lnperature(RRT)if sampled within one hour of receipt. Client contact for temperature failures <br /> must be document d below_ If many packages are received at one time check for tests/H.T.Wrushes/Bacti's to <br /> prioritize further r view, Please notify Microbiology personnel immediately of bacti samples reccived.. <br /> I. leo the mimher Tit hoiIir.� Tec eivrd �1VTee with the COC? /, es ) No N/A <br /> 4. Were samples ceived intact? (i.e no broken bottles, leaks etc.) No <br /> G \\/ewe nnw•.rlo m n+nrt.r Tonic. in4-..�t'� Til/q 1 YPe �lfl <br /> Sign and date the C C, place in a ziplock and put in the same ice chest as th pies <br /> Sample Receipt Revi w completed by(initials): <br /> Sample Receipt at S : <br /> 1. Were samples r ceived in a chilled condition? Temps: <br /> Acceptable is abov,freezing to 6°C. if manv packages are receivcd at one time check for tests/H.T.'s/rushesBacti's to <br /> prioricizc further revi w. Please notify Microbiology personncl immediately of bacti samples reeceivcd. <br /> 7 Do tTiP niirnher f hnttlPc rPCPivPd agree with the COC? //Yes-) No NIA <br /> 3. Were samples r ceived intact? (i.e. no broken bottles,leaks etc.) Q*y- W No <br /> 4. Were sample cu tody seals intact? NIA Yes No <br /> v;or, anri dgtt-rhe f n nhtpin r.TMC samnlP mtmbers_ select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all reques ed analyses understood and acceptable? o <br /> 2, Did bottle label cur C$puita WAII the cllent's ill's? Yes o <br /> 3. Were all bottles equiring sample preservation properly preserved? s NoN/A FGL <br /> 4. Were all analyse within holding times at time of receipt? No <br /> 5. Have rush or pr ect due dates ween checked and accepted'! ((N/ es No <br /> Attach labels to the c tainers and include a copy of the COC for lab deli <br /> Sample Receipt.Logi and Verification completed by(initials): <br /> Discrepancy Docume tation: <br /> Any items above whit are"No" or do not meet specifications(i.e.temps)must be resolved, <br /> 1. Person Contacte Phone Number: <br /> 1n1l1dlCU i3;: _ ua�c• <br /> Problem: <br /> Resolution: <br /> Attach label with lab number here <br />