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FGL Environmental Doc ID: 3DO900002 Revision Date: 10/09/14 Page 1 of 1 Inter- ratory Condition Upon Receipt (Attach to CO( Sample Receipt at; /,, -ST CC CH VI 1. Number of is chest ages received: _Shipping tracking # 2. Were samples received in a chilled condition? Temps:/ / / _ Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I0' C, whe should be flagged unless the time since sample collection has been less than two hours. 3. Do the number of bottles received agree with the COC? No 4. Were samples received intact? (i.e. no broken bottles, leaks etc. No 5. VOAs checked for Headspace? Yes No 6. Were sample custody seals intact? Yes No 7. If required, was sample split for pH analysis? No 8. Were all analyses within holding times at time of receipt?es No 9. Verify sample date, time and sampler name Yes No Sign and date the COC, place in a ziplock and put in the same ice chest as samples. Sample Receipt Review completed by (initials): "-Elio ZZ3745i�z iced or not, N/A Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps: Acceptable is above freezing to 60 C. If many packages are received at one time check for tests/H.T.'s rushes/ 2.Shipping tracking numbers:�� / 3. Do the number of bottles received agree with the COC? No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No 5. Were sample custody seals intact? Yes No Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print 1 be�N/, Sample Verification, Labeling and Distribution: 1. Were all requested analyses understood and acceptable? es No 2. Did bottle labels correspond with the client's ID's? es No 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL [Exception: Oil & Crease, VOA and CM verified in labl 4. VOAs checked for Headspace? Yes No 5. Have rush or project due dates been checked and accepted? Yes No 6. Were all analyses within holding times at time of receipt? & No Attach labels to the containers and include a copy of the COC for lab delivery. 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 res lved. 1. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: 2. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: (Please use the back of this sheet for additional comments or Attach label ith lab number here contacts)