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FGL Environmental Doe Ill: F3REC005.005 <br />Revision Date: 2/13/09 Page: 1 of 1 <br />Stockton - Condition Upon Receipt (Attach to COC) <br />Sample Receipt at STK: <br />I . 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 some 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 bac "iaTples received.. <br />3. Do the number of bottles received agree with the COC?Y' No NIA <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />5. VOAs checked for Headspace`? �es .� )No NIA <br />6. Were sample custody seals intact? Yes No <br />Sign and date the COC. place in a ziplock and put in the same ice chest as the sen <br />Sample Receipt Review completed by (initials):.— <br />6 <br />Sample Receipt at SP: <br />I . Were samples received in a chilled condition`? Temps:-/-/-/-/ <br />Acceptable is above freezing to 6° C. If many packages are received at one time check for <br />tests/l-I: rs/rushes/Bacti's to prioritize further review. Please notify Microbiology personnel <br />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.e. no broken bottles, leaks etc.) !9No <br />4. Were sample custody seals intact`? No NIA <br />Sign and date the COC. obtain LINTS sample numbers, select methods/tests and print labels, <br />Sample Verification, Labeling and Distribution: <br />1. 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 N/A FGL <br />4. VOAs checked for lMeadspace? es No P--kl <br />5. Were all analyses within holding times at time of receipt? Yes No <br />6. Have rush or project due dates been checked and accepted? Yes 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 />Discrepancy Documentation: <br />Any items above 1vhich ar" r do t t meet specifications (i.e. temps) must be resolved. <br />1. Person Contacted: f� !_ Phone Number: <br />Initiated By: <br />Proble3; (3-8692 ) <br />Forward Inc <br />Resolution: <br />Pal Y'al <br />t�JU-�• <br />Us tt <br />IV -08/18/2011-09:22:13 <br />re <br />