Oregon State University North Willamette Research & Extension Center IR-4 Research Center Aurora, Oregon Joe DeFrancesco: IR-4 Field Research Center Director, State Liaison Representative Gina Koskela: Field Research Director, Archivist Peter Sturman: Field Research Director
Test Substance Receiving Instructions Copy shipping label on shipping box Open and check contents of shipping box If packaging or container integrity has been compromised, photograph/ record and report any issues Print copy of Test Substance Receiving Document and complete top section
Test Substance Documentation as received Trial ID # (s) Date t.s. Received MSDS Supplied with sample? C of A Supplied with sample? Information Source Protocol T. S. container label Certificate of Analysis MSDS Product Name/Formulation Active Ingredient(s) Chemical name(s) Active Ingredient Concentration EPA Registration Number CAS number Lot/batch number NA Condition N/A N/A NA Quantity Received N/A N/A NA Expiration date N/A NA GLP charecterized required NA
Test Substance Receiving Instructions Read Section 13. Test/Control Substance in Protocol and record information in Protocol column on Test Substance Receiving Document Product Name • Active Ingredient • AI concentration • EPA Registration # • CAS # •
Test Substance Receiving Instructions Fill in columns on Test Substance Receiving Document using information provided by T.S. Container Label • Certificate of Analysis (COA) • Safety Data Sheet (SDS) • Where information is not provided, enter “Not Stated” or something similar, in appropriate space on the Test Substance Receiving Document Check COA and T.S. Container Label for GLP Compliance Statement and Expiration Date Compare information from T.S. Container Label and COA and SDS with language in Section 13 of protocol
Test Substance Documentation as received Trial ID # (s) 11743.16-OR315 Isoxaben Hops Date t.s. Received 1/20/2016 SDS Supplied with sample? Yes C of A Supplied with sample? Yes Information Source Protocol T. S. container label T.S container overbag Certificate of Analysis MSDS Product Name/Formulation Trellis SC Trellis SC Trellis SC Not stated Trellis SC Product Number Not Stated TSN309045 TSN309045 TSN309045 not stated Active Ingredient(s) Chemical name(s) Isoxaben 500SC Not stated Isoxaben Isoxaben not stated Active Ingredient Concentration 4.16 lb ai per gallon Not stated 45.45% 44.8 wt% 45.45% EPA Registration Number 62719-659 Not stated Not registered not stated not stated CAS number 82558-50-7 Not Stated not stated not stated 82558-50-7 Lot/batch number not stated Not stated D509E8S001 D509E8S001 NA Condition N/A Good Good N/A NA Quantity Received N/A 100 ml not stated N/A NA Expiration date N/A 1/13/2017 1/13/2017 1/13/2017 NA GLP charecterized required not stated not stated Yes NA
Test Substance Receiving Instructions Assign unique container ID# to each test substance container using sequential numbering system as per SOP’s. Record on sheet in IR-4 office Apply trial ID sticker from FDN to container label. Create and apply to container label the following information if it is not already on the label: Unique test substance container ID# • Chemical name of test substance • FRD initials and date •
Test Substance Receiving Instructions Place test substance container in sealed plastic bag and place in secure IR-4 chemical storage unit with temperature monitoring device. Place SDS in IR-4 current year binder in chemical storage building. If conducting multiple trials of the same test substance, copy all documents originals, stamp as true copies and place in appropriate FDN Determine that sufficient quantity of test substance has been supplied to complete all trial(s) applications.
Test Substance Receiving Instructions Place all documents in FDN Copy of shipping container label • Copy of t.s. container label • Bill of Lading • COA • Chain of Custody letter • Safety Data Sheet (SDS) • Portions of Product Label if possible •
Test Substance Receiving Instructions Complete FDB Parts 4 A and 4B Communicate in FDB Part 3 If required, sign Chain of Custody letter and send back to registrant E-mail study director completed Test Substance Receiving Document form with a cover note bringing attention to any discrepancies and any other issues concerning check-in of test substance
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