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FGL Environmental Doe ID: F3REC005.005 <br /> Revision Date: 2113/09 Page: 1 of t <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: /��y� <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 dayo sampling or <br /> received at room temperance(RRT)if sampled within one hour of receipt. Client contact for to eramre 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 bTNo s received.. <br /> 3. Do the number of bottles received agree with the COO No N/A <br /> 4. Were samples received intact'? (i.e.no broken bottles. leaks etc.) No <br /> 5. VOAs checked for Headspace? <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 sa <br /> Sample Receipt Review completed by(initials): <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 fbr <br /> tests/H.T.'s/mshesBacti's to prioritize further review. Please notify Microbiology personnel <br /> immediately ofbacti 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.) No <br /> 4. Were sample custody seals intact? s No /A <br /> Sign and date the COC. obtain LIMS sample numbers, select methods/tests and print labels. <br /> NI <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? No N/A FGL <br /> 4. VOAs checked for lieadspace? &YeeNoN/A <br /> 5. Were all analyses within holding times at time of receipt? 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 de �J <br /> Sample Receipt,Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> Any items above which arc"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: (3-11544) <br /> Musco Family 01 1 v Envi onmental <br /> STK11380 7 <br /> NMB-09/15/2011-09: 5:47 <br />