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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOO, <br /> CLIBNT NAME. i DATF-Recev ed at Lab. (Drinking wafer)for <br /> RF.C.I3Y(1'RJ]`II) TMIX Received at Lab- regulatory purposes: YF.S 18 <br /> `4'VORKOItT} U; — k �'� LOG IN DATE; k (Was(ewater)for <br /> regulatory purposes: ! T <br /> CIRCJ.-TIE APPROPRIATE RESPONSE LAB SAM P-E0 DATF <br /> SAMPLE# 9 CI,J ENT ID DE.SCUPTION MATRIX SAMPLED CONDITION(ETC) <br /> 1 Custody Seal(s) PfescutAhollt <br /> - IntaC[!B en� <br /> 2 ChamDf-rslot! RCs4rff bsent� <br /> 3 Itafkic�kCporLs ar <br /> 1'ackin List 1?rescait n <br /> 4 Alrblll �11rb1I11 <br /> kIMM,t� bseu <br /> 5 Airbill ff. <br /> G Sang la l;,abcls: t/Abs cnt <br /> 7' Ssrrmpjams l rst J?+Iokl.isted <br /> ry <br /> on Gram-of-Cllstad <br /> 8 Sample Condtlton- tact Brokeu*I <br /> m � <br /> 9 )IM Information on <br /> custody reports,traffic <br /> reports Sud sample <br /> labels a me? o* <br /> 14. &ample 3recerved within <br /> hold(nne Zoo* <br /> 11.Prosser l'txservatives <br /> used No's <br /> 12 Tunp Hoc at Jab: <br /> (Acceptnace rhe for samples <br /> MI'llyiniZ thermal Dre3 4f!-209yes/NCF* <br /> °Xf Circicr�,cou#trct Traject Marna er sand attach record of resalution. <br /> - Sampie Recarpt Lng <br /> Re*1on 21 (1111 OM) <br /> Rep�tfe"fl2}Qp 2(1 iH}GA74) � Page <br />