Laserfiche WebLink
i <br /> 0 <br /> SEQUOIA ANALYTICAL SAMPLE RECE PT LOG <br /> CLIENT NAME �� > DATE Received at Lab. 04 (Driuking water) for <br /> k REC,BY(PRINT) TIME Received at Lab: ## regulatory purposes YES/NO <br /> WORK0 1) LOG IN DATE: 1� (Wastewater)for <br /> regulatory purposes YES/NO <br /> CIRCLE'I IIE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONd1T101V (E f C) <br /> I Custody Seal(s) Present/ sen nrr ~�` <br /> lataW Broken* Ck <br /> �D <br /> 2 Cliatti-of-Custodyrese tlAbsent* -S 1./ ' S <br /> 3 Traffic Reports or ��I $ <br /> Packing List Present Kbst 3 `� <br /> 4 Airbill Airbill l Sticker <br /> Nm- <br /> PresentLggi <br /> 5 Aubill# <br /> 6 Sample Labels /Arese t/Absent <br /> 7 Sample 1Ds ! e5l/Not Listed <br /> on Chain-of-Custody <br /> 8 Sample Condition n 1 Broken*/ <br /> Leakin <br /> 9 Does iritomiation on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? /No* <br /> 10 sample received within <br /> hold time 1 No* <br /> I 1 Proper Preservatives <br /> itsed 1 No* <br /> 12 1 emp Kee at Lab 3 <br /> (Acceptance range for sairiples <br /> leguirilig the,ma! pres A+1-2°C) /No* <br /> < (4< r .f- -1 x a -- - <br /> *II Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt log <br /> Revision 21 (1 U10/00) Page of <br /> Replaces Revision 2(11106!00) <br />