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TGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> Stockton - Condition Upon eceipt (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/rushesBacti'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? es No N/A <br /> 4. Were samples received intact?(i.e.no broken bottles, leaks etc.) No <br /> 5. 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 t11 sp Ales. <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 tests/H.T.'s/rushesBacti's to <br /> prioritize finther review. Please notify Microbiology personnel immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? Ye No N/A <br /> 3. Were samples received intact? (i.e. no broken bottles, leaks etc.) a <br /> No <br /> 4. Were sample custody seals intact? 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? Ye No <br /> 2. Did bottle labels correspond with the client's ID's? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No {:!�� 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? /A 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 which are"No" or do not meet specifications (i.e. temps)must be resolved. <br /> I. Person Contacted: Phone Number:---- <br /> Initiated <br /> umber:___Initiated By: nate: <br /> Problem: (3-12203) <br /> Resolution: <br /> Scats Hyponex Corporation <br /> S 3 3 4 <br /> -i0:f9:26 <br />