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i ! <br /> SEQUOIA ANALYTICAL_SAMPLE RECEIPT LOG <br /> CLIENT NAME- - DATE Received at Lab- <br /> CLIENT (Drinking water)for <br /> REC BY(PRINT) TIME Received at Lab: 15 regulatory purposes YES/NO <br /> WORKORDER d LOG IN DATE- — 5(�-00 (Wastewater)for <br /> regulatory purposes YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> I Custody Seal(s) Presense AVS A Y <br /> Inca Bro en* <br /> 2 Cham-of-Custody Ptese.0 Absent* <br /> 3 Traffic Reports or <br /> Packmg List Present/fflsenj <br /> 4 Airbill Airbill/Sticker <br /> Present/ e t <br /> 5 Attbtll# <br /> 6 Sample Labels eset /Absent <br /> 7 Sample IDs Foncliaiii-of-Custody <br /> /Not Listed <br /> 8 Sample Condition /Broken*/ <br /> Peaktng* <br /> 9 Does infoimation on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? /No* <br /> 10 Sample rcceived within <br /> Bold time e /No* <br /> Ll Proper Preservatives <br /> used N/No* <br /> 12 Temp Rec at Lab vl <br /> Acceptance range for samples <br /> �ecjuirm&thermal res 4+/-2°C) * _ <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 2 1 (1Ill 0(00) ; ' <br />