Laserfiche WebLink
! ! <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG 4 <br /> p <br /> CLIENT NAME; DATE Received at Lab; 2--1 C-" (Drittlung water)for <br /> REC BY (PRINT) TIME Received at Lab: 4c; <br /> regulatory purposes YES/NO <br /> WORKORDER $S LOG IN DATE: 2 (Wastewater)for x <br /> F <br /> regulatory purposes; YESlN0 <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> I SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> I Custody Seat(s) rose t/Absent <br /> i <br /> Antt/Broken* <br /> 2 Cliatn-t)f-Custodyt!Absent* <br /> 3 Traffic Reports or ,may <br /> Packing List Present <br /> 4 Atibill Airbtll I Stec er (p <br /> Present/ set <br /> 5 Atlbill# <br /> 6 Sample Labels Rgnt/Absent ) �3 <br /> 7 Satuple IDs !Not Listed 0 VQ Z <br /> Chain-of-Custody1 ( ; <br /> 8 Simple Condition ct!Broken*/ 2- <br /> Leakin * ,3 <br /> 9 Does m1bitnatton on y 5 <br /> custody reports, traffic ( � <br /> reports and sample <br /> labels agree? !No* {� <br /> t <br /> 10 Sample received within <br /> hold tune /No* <br /> 11 Proper PreservativesPr <br /> s/No* 7j T <br /> 12 Teuip Ree at Lab 2Z 2 <br /> (Acceptaiice range for samples <br /> lecuirin,t11er1nal res 4}/-2°C) e /No* Z 3A- <br /> Jt <br /> *If Circled, c nta t Pi o'ect Manager and at ach record o resolutio . <br /> Sample Receipt Log <br /> Recision 2 1 (11/10100) <br /> Replaces Revision 2(11106M) Page of <br /> FffPrhv*11/171nn <br />