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FGL Environmental Doc ID: F3R C00S.005 <br /> Revision Date: 2113109 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STI:: <br /> 1. Number of ice chests/packages received: <br /> ?. Were samples received in a chilled condition? Temps: Aff/ ! 1 ! <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.'slrushesBacti's to <br /> prioritize further review. Please notify Microbiology personnel inunediately of les received.. <br /> 3. Do the number ofbottles received agree with the COC? o N/A <br /> 4. Were samples received intact?(i.e.no broken bottles. leaks etc.) o <br /> S. VOAs checked for Headspace? Yes o <br /> 6. Were sample custody seals intact? Yes No A <br /> Sign and date the COC. place in a ziplock and put in the some ice chest as the s <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 1 1 I <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for <br /> testsfH.T.'s/rushesBacti'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 NIA <br /> 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) No <br /> 4. Were sample custody seals intact? a No NIA <br /> Sign and date the COC_obtain LIMS sample numbers,select methods/tests and print labels. <br /> Stemple Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's en's? No <br /> 3. Wcrc all bottles requiring sample preservation properly preserved? 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? JesNo <br /> 6. Have rush or project due dates been checked and accepted? Yes No Nl! <br /> Attach labels to the containers and include a copy of the COC for lab del:Z�r <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 8y: Dale: <br /> Problem: <br /> (3-w_5441 <br /> Resolution: ' <br /> M �`r tare: �t: 1 t11� wrta,rVJ+, ' M <br /> ..v�.J�/ L ..�iir 4�. 4 u+i� �s6 L:+ lYMl <br /> SmK10510b8 <br />