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81-1 UOIA ANALYTICAL SAMPLE, RECEIPT LOG <br /> CL F.NT MAW: -� DATE Received a t Lab l - (DrInlang water)for <br /> REC.BY(PRWT) T=Received at Lab: regulatory purpwes. Y 'O <br /> SVOI2KORDER: <br /> LOG IN DATE: Q (Waslowater)tot- <br /> regulatory <br /> orregulatory purpnsea- 0 - <br /> - <br /> MCLE'>.M APPROPRIATE RESPONSE LAB SAMPY,E 1 DATE <br /> SAM LE# # CLIENT l) DMCREMON MK RIX SAMPLED CONDrIrON(JFTC.) <br /> 1. owodyscal(s) PMell t bs nt <br />� Intact r <br /> 2 Cbnan-of•Llistod resent bsen t} <br /> 3 TrafEc Reports or <br /> Pack List Present A <br /> 4 Akbrtl. AlibilltSb er <br /> - l'rrscnt l lss <br /> 5.�S�rbsll lJ <br /> ti Sam le Lags Pee t f Abient <br /> 7. sample as, s /Not Listed <br /> Maui-of-G�stad <br /> S.Sample-Condition PTRY Braked*1 <br /> r <br /> 9 Does mfurm moa oR <br /> custody reports,tmf 1io <br /> reports and sample <br /> labels arjw7 1N0* <br /> 10. Sample received within <br /> hold tin t C No* <br /> 11, kroperAmervatives <br /> t�se�l• <br /> AlNo* <br /> 12 Temp Rcc of Lab, <br /> (Acceptance range fnr samples <br /> nuins thermal prag 4t1-2°C) Yes/No" <br /> W Circled,contact Project Manager and Fitfach record of resolu iott. <br /> Sa�npb it9wipt Ilag <br /> Re 21(1M)RepLxes Revslon 2(1 i00) Pa a�of <br /> t;rTecinre I11�2IU0 <br />