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i FGL Environmental Doc Ill: F3REC005.005 Revision Date: 2/13109 Page: 1 of 1 Stockton - Condition Upon Receipt (Attach to COC) Sample Receipt at STK: 1. Number of ice chests/packages received: 2. Were samples received in a chit led condition? Temps:/2& / / ng or Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROI) for the same day-of sampli received at room temperarure(RRT) if sampled within one hour of receipt. Client contact for temperature failures trust be documented below. If many packages are received at one time check for testi/H.T.'s/nishes:Bacti's to prioritize further review. Please notify Microbiology personnel immediately of b• ' tles received.. 3. Do the number ec bottles received agree with the COC? �o N/A 4. Were samples received intact?(i.e. no broken bottles. leaks etc.) No 5. VOAs checked for I leadspace? Yes o� 6. Were sample custody seals intact? Yes No N/A Sign and date the COC. place in a ziplock and put in the same ice chest as the sa�tp s. Sample Receipt Review, completed by(initials): n Sample Receipt Sp: — I. Were sampless "T received in a chilled condition? emps: /H/ Acceptable is above freezing to 6°C. If many packages are received at one time check for tests!II.f.'s/rushes/Banti's to prioritize further review. Please notify Microbiology personnel immediately of bacti samples received. 2. Do the number of bottles received agree with the COC? No N/A 3. Were samples received intact?(i.e.no broken bottles, leaks etc.) o 4. Were sample custody seals intact? es No N/ Sign and date the COC. obtain LIMS sample numbers, select methods/tests and print labels. Sample Verification, Labeling and Distribution: 1. Were all requested analyses understood and acceptable? Yes No 2. Did bottle labels correspond with the client's ID's? No 3. Were all bottles requiring sequple preservation properly preserved? No N/A FGL 4. VOAs checked for I leadspace? No N/A S. Were all analyses within holding times at time of receipt'? No 6. Have rush or project due dates been checked and accepted? Yes No N//A Attach labels to the containers and include a copy of the COC for lab de ry Sample Receipt, Login and Verification completed by(initials): Discrepancy Documentation: Any items above which are"No"or do not meet specifications(i.e. temps)must be resolved. 1. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: (3-11544) HMO Family Olive Environmental STK1251603 NMB-12/21/2012-12:00:56