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1 i 1 I 1 I i I i 1 1 1 I 1 I I i i I <br /> SEQUOU ANALYTICAL SANT LE RECEIPT LOG <br /> CLEENT NAIL: _I1�L� DATE Rieceived at Lab: /0-03-02- Drmkin.-water for <br /> RtEC RY(PRMM TZW Received at tab; lC{ regulatory <br /> WORKORDER: apnrposcs: S'ES N <br /> 't'ILJ6G�:r3�, _ R.OGL`1DATE: Jb..�c-•6Y V4stmaterfor <br /> regulatory purposes: YES NO <br /> CIRCLE TT1F APPROPRiATF RESPnV Cr .n, CONTATNR R SANRPLE DATE <br /> SAM CL.MNT 1D <br /> AESCRRPTTO-N MATRTX SAWL LW CONDITION(FTC.) <br /> 1. CusiodySeai(s) Present •eat l 1 �I Y3 j7 (r tfi.tnE�'a. � s �DrLZroL <br /> Intact/Bro en* I <br /> 2. Chain-0f-costod Pres !Absent" -3 <br /> 1 Traffic Reports or TS-L{ 'S' <br /> Pack List Present/ Swan S P9-5 WISP <br /> 4.AL-bilk Airbi$I Sti &� <br /> Present/ ant �- <br /> $ 5.Airbill it: S- <br /> 6. SamolcLabelsc ns Absrnt 7 •3 r(=,' <br /> 7. SampoIc : i Not Listed tG <br /> on'Cbain-of <br /> 8. Sample Condition: Broken*/ <br /> 4. Does infolmarion on <br /> i custody reports,traf#ic <br /> reports and sample <br /> labels agree? Y INo*, <br /> 10. Samplereocivedwithin <br /> holditr7 e ° 1No* <br /> fi 11.Proper Presem,tivds <br /> used: <br /> 12. Temp Rec.at Lab: (o,D <br /> p (Accept==range for sampl:s <br /> •quiringthermaIPres..4+•/-2°C) 1r Na"« <br /> c tion f <br /> *If Circled' contact Project Manager and attach record of resolution. <br /> sample Reeeipt Log <br /> 1$1"12(D4/11102) <br /> laces <br /> Reelson2.1 (2111MG) Page of �� <br /> •Ire 04/19J02 <br />