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SEQUOIA ANALYTICAL SAMPLE RECEIP11 LOG <br /> CLIENT NAME: DATE Received at Lab: �J (Driaakuag water)for 4 <br /> REC. BY(PRINT) TIME Received at Lab: regulatory purposes. YESINO <br /> WORKORDER: LOG IN DATE: ) (Wastewater)for <br /> S <br /> regulatory purposes. YES/NO 4 <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX S LED CONDITION(ETC.) <br /> 1 Custody Seal(s) 1 Absent <br /> k Broken* <br /> 2 Cliain-of-Custodyreset Absent* <br /> 3 Traffic Reports or <br /> Packing List Present �e <br /> h 4 Arrbill Arrbill/Sticker <br /> Present bsen <br /> 5 Airbill# <br /> 6 Sample Labels Absent <br /> 7 Sample IDs Lrsted Not Listed 36 <br /> onChain-ofCustod <br /> 8 Sample Condition (EDYBroken*Leaking* <br /> 5 <br /> 4 Does information on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? Ye No* <br /> 10 Sample received witlun ;t <br /> i <br /> hold time No* <br /> 11 Proper Preservatives <br /> used Ye /No* <br /> 12 Temp Rec at Lab <br /> (Acceptance range for samples <br /> requiring thermal res 4+1-2°C) o* , <br /> 11r, Fu»nf x far ow\ a f 77 -1. 777 11171 <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br />