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A <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: Ugs— -P DATE Received at Lab: Q (Drinking water)for <br /> i 4 <br /> ti REC. BY(PRINT) TIME Received at Lab. regulatory purposes. YES/NO <br /> 1 WORKORDER• [ LOG IN DATE: (Wastewater)for <br /> regulatory purposes: YES/NO <br /> a <br /> a CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC) <br /> a <br /> I Custody Seal(s) kInta <br /> /Absent <br /> Broken* <br /> 2 Chain-of-Custod res /Absent* <br /> 3 Traffic.Reports or ,;zx <br /> Packing List Present/ <br /> 4 Anhill Airbill/Sticker <br /> 3 <br /> Present/ se t <br /> 5 Airbill4 <br /> 6 Sample Labels re t I Absent <br /> 7 Sample IDs este /Not Listed j <br /> on Chain-of Custod <br /> 8 Sample Condition n t/Broken*! <br /> Leaking* <br /> 9 Does infornnation on <br /> custody reports,traffic n <br /> reports and sample <br /> labels a ree? Y !No* <br /> n <br /> 14 Sample received within t <br /> hold trine I No* <br /> I I Proper Preservatives <br /> used Y !No* <br /> 12 Temp Rec at Lab <br /> „(Acceptance range for samples <br /> Maguirig tliernW Pres-4+1-2°C) ej3p1 No* <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 21 (11110=) <br /> Replaces Revision 2(11106M) Page of <br />