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FGL Environmental Doc ID: F3REC005.00-5 <br />Revision Date: 2/13/09 Page: 1 of I <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/rusbes,'Bacti's to <br />prioritize further review. Please notify Microbiology personnel immediately of bacg-saij�les received.. <br />3. Do the number of bottles received agree with the CDC? k, No N/A <br />4. Were samples received intact? (i.e. no broken bottles; leaks etc.) I=s 1 No <br />5. VOAs checked for Headspace9 No r <br />6. Were sample custody seals intact? Yes No r' N <br />Sign and date the COC. place in a ziplock and put_ in the same ice chest as the`san es. <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 at one time check for <br />tests!B.T.'s/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.) a No r �. <br />4. Were sample custody seals intact'? Yes No N/A <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 />?. Did bottle labels correspond with the client's FD's? Ye No <br />3. Were all bottles requiring sample preservation properly preserved? Yes No N/A FGL <br />4. VOAs checked for Headspace? No N/A <br />5. Were all analyses within holding times at time of receipt'? Ye No <br />6. Have rush or project due dates been checked and accepted? Yes 'ONHA' <br />f <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: <br />Resolution: (3-2956) <br />f` 3 7o i n pp l�1§1'I=�i S(i l ' fl �1� oste <br />6JJan 41U 1.1 4J'�iLj � s � � <br />®, <br />SPIP-04/03/2013-13:10:53 <br />