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i i • J <br /> SEQUOIA.ANALYTICAL SAMPLE, R .CEIPT LOG <br /> CLIL, NT NAME DATE Received at Lab- (Iltitlkiug water) for <br /> REC UY (PRIM) TIl1IE Re(elved at Lab: _ regulatory puiposes YI<S1NO <br /> WORKORI)LIt LOG IN DAIS: —� — (Wnste`vater) for <br /> regUTAOry purposes- YES/NO <br /> CIRCLE I[)L U'PROPRUTE RESPONSE LAB SAMPLE DATE <br /> SAMPLE,# # CLIEN F 11) USCIRP HON MA 1 Iux S It' EI} CONDI I ION (IrTc) <br /> 1 custudt Seatl(s) <br /> '77 63 <br /> �Jtltx�B;Ukul- <br /> 2 <br /> 'L <br /> Clwin-of-Cttstud3 set Absent* <br /> 3 rwftiL Rcpus is ul <br /> Pd(,kinR List Plesellt Abse i <br /> 4 Aubtll Auld!/ Sucker t <br /> Plesent <br /> 5 Aitbill# ' ` <br /> G Sate lc Labelsreser Absen( q 2 63 <br /> 7 SaiuphL 1Dststed Not Llstod <br /> t <br /> _ urs.Chant-of-Custody <br /> 8 Simple condition luta I Broken*! <br /> Leaking* <br /> 9 Dues IlLfbi awtion oIl <br /> (.listud) Iepults, ttalllc <br /> rq)uitS,Iwl Sample <br /> 1,6,15 a lee? Y No* <br /> 10 Sample �Wllln <br /> _ hold tuilces No* -� <br /> 11 Proper Pi(.sQi wtn cs � <br /> used _ Y 1 No* <br /> ' 12 1'ctnp Ree at Lab --7 --s <br /> (AL4.puuw unge for samples 3A _ <br /> IL(Jttttitsb tliCIJUJI eies a b/-2°C) e /No* <br /> *If Circled, contact Pi affect managel azul (attach t ecot d of resolution. <br /> Sampo a Re"Ipt LOS <br /> Revisiori 2 t (t MOO)) <br /> RCJAA.L5 Ratiistuu 2(I If(}UO) page _ of <br />