Laserfiche WebLink
SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab: 74- /p L/ (Drinking water)for <br /> C•BY(PRINT) TIME Received at Lab: /I/V regulatory purposes: YES/NO <br /> WORKORDER: LOG IN DATE: (Wastewater)for <br /> regulatory purposes- YESINO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPVD CONDITION(ETC.) ; <br /> f <br /> 1 Custody Scal(s) resent Absent — /21 C �5 <br /> Intac Broken* <br /> 2 Chatti-of-CustodyPrese /Absent* <br /> 3 Traffic Reports or <br /> Packing List Present 1 sent <br /> 4 Airbill <110 Sticker <br /> Prese /Absent <br /> S Airbill# S 5 S3S Z <br /> G Sam ie LabelsAt�Not <br /> Absent <br /> 7 Sample IDs Listed <br /> on Chain-of-Custody <br /> 8 Sample Condition arta /Broken*/ <br /> k i <br /> Leaking* <br /> 9 Does miforniatlon on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? e !No* <br /> to Sample received within <br /> hold tante Y /NO <br /> 11 Proper Preservatives <br /> used Yes No* <br /> L <br /> ec at Lab range for samples <br /> ermal res 4+-/-2°C) es No* <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Log <br />