Laserfiche WebLink
• i s <br /> SEQUOIA ANALYTICAL SAMPLE RECEIP T LOG <br /> CLLEN J NAME: «>� P DATE Received at Lab: (Drinking watet) Gti <br /> ItEC BY (PRIM 1) TIME Received at Lab: regulatory pui Hoses y KS/N0 <br /> WORK011PER LUG IN DAIE, (Waomater)for <br /> regulator y llltt 1)oce9 I r ENO <br /> n <br /> x <br /> CIRCLE T)IE APPROPRLATE KESPONSE LAR 5A14IJ'LE DATE t <br /> SAMPLE it # CLIEN 1 W DESCRLP[ION NIATII~IX SA.h'!.I D CONtlII ION (ETC) <br /> b 1 Custody$c<i1(s) res rt!Absent <br /> utz l 113 roken* <br /> 2 Cliaiti ol-Castod t Absent" <br /> 3 Cratric iii Is or - <br /> Packm last Present <br /> 4 Aiibilt Aubill I Sttc <br /> _ Present/kisod --- <br /> 5 Anbill tl ri D <br /> 0 Sample Labels res t 1 Absent �m <br /> 7 Sample IUs 4 is d I Not Listed _ <br /> on Chatty-of-Cuslod E _- <br /> 8 Sample Couditioti Oki.I Broken* <br /> Leaking* 7`7U <br /> 9 Does mfoimalitin on <br /> custody reputts, traffic <br /> repoils and sample <br /> libels a reelOf <br /> Y Na* <br /> FTemp <br /> w(xived�vt[liut — <br /> e I No" <br /> !No* <br /> ec, at Lab <br /> (A.cceptarnce targe rot samples <br /> ie imin g tlieitnal pies 4+1-2°C) 6y' Noy <br /> t N i Ib C �+" rF i�a. r,b.d/Fb f.._• 4 Sotwiiah,A .>.6�>a� C.- v w..— r-.- x �".r.v. S' � v < a4..-,w!a ax ry+A4Yf u.w .,C ..� r-n -� -.,........ ........� <br /> ,if Cticled, Contact Piolect Manager and attach iecoitl of resolut[o". <br /> Sample Receipt Log <br /> Revision 2 1 (11110100) Page <br /> ReplacF s Revivan 2 f 1106100) <br />