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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> H <br /> CLIENT NAME: <br /> L� . DATE Received at Lab: -3/4,S v {Dnnlufag water}for <br /> REC BY(PRINT) TIME Received at Lab: 0-0 regulatory purposes: YES/NO <br /> WORKORDER LOG IN DATE: a (Wastewater)for ' <br /> regulatory purposes: YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE a <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAAJPLED CONDITION(ETC) <br /> I Custody Seal(s) resent Absent C7777. <br /> Intac Broken* <br /> 2 0win-of-CustodyPrese /Absent* <br /> 3 Traffic Reports or <br /> Packing List Present! sent <br /> 4 Airbill Sticker <br /> } Prese /Absent <br /> 5 Airb ?KLS3SIfa <br /> 6 Sample Labels r Absent , <br /> 7 Sample IDs is Not Listed: <br /> on Chaan-of-Custod <br /> 9 Sample Condition nta /Broken*! r <br /> Leaking* , <br /> 9 Does information on <br /> 0 <br /> custody reports,traffic <br /> h <br /> reports and sample <br /> labels a reel /No* / <br /> 10 Sample received vntlun <br /> hold time <br /> /(5;)/No" <br /> I I Proper Preservatives <br /> used Yes No* <br /> , 12 Temp Rec at Lab <br /> t <br /> (Acceptance range far samples <br /> requiring th rmaf pres 4+/-2°C) 6esNo* <br /> *If Circled, contact Project Manager and attach record of resolution. v y <br /> Sample R Log <br /> Revision ltolpp) <br /> RePMemM 1106- rst m m m ' F� <br />