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• 0 <br /> SEQUOIAANALYTICAL I'ICAL SA.tMPL R ECEI -I'LOG <br /> CLIENT NAM F,; � DATE RereiYed at I,ab: —� �+�.p� Drinking water for <br /> RE C.BY(PRTNT) f TIOUR Received at I.ah- _ / -.-Leg regulatory purpos ' <br /> � es: <br /> WORKOADER: f L LOG IN DATLO: 9 r/ Wastewater for <br /> regulatory purposes: YrS O <br /> CIRCLE TITE APFROPRtATF UFSPONSE LA13 CONTATNI+.il SANIPLE DATE <br /> TtE4iARKS: � <br /> SANIPLEfl 0 CLIENT JD i)l-wr.itlwy10.%4 AfATRIX SAAfFLED cmDTI` o C. ' <br /> 1. Cus tody sc3f(3) Pfesent f sen C <br /> Intact 1 Broken* cry <br /> 2. Chain•of.Cugtod ' is /Absent' a' tl <br /> 3.Trafrio RcporU oir <br /> t <br /> Packing List: Prc.;eul �►6se <br /> d. Airbi11; . Airibill f Silo <br /> Present a Wo <br /> S. Airbill ff- <br /> 6. Sam to Labols: i /Absent <br /> 7.Santiple]Ds: Lia Notl.lsfcd <br /> o .h1in•nf-C.�stod <br /> S.Sample Condition. Qntac Brolce�x*! <br /> T_cskin t <br /> 4. Does information pn <br /> custody reports.Ira in <br /> reports and sample <br /> labels a lee? NO* <br /> I& Sample Tcccivoti%milhin <br /> i hold timo`. Nn* <br /> I I. Praper Pre ervalives <br /> used: o* <br /> ' 12.Temp Ree.at Lab: , <br /> (Accaptance range for samples <br /> requiring thermalprms.:4+12"C) Yes No** <br /> #'Exec tion(if an -�.�--� <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sampla Receipt Los <br /> RovTsTon 2.2(04111102) - <br /> Replacas.Ravlston 2.1(11110100) Rage--Z_of, f <br />