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SE U01A ANATNTICAL SAMPLE RE,CL,IPP LOG <br /> = <br /> a.,� • r - <br /> CLEENT P[AML�• r.uex Dfi'!'l8]teceivea at Lab- (Drinking water}for <br /> RFC BY ij{P+t� IMERcccef ed at 1,11 b. � - regutttory purposes. 't' <br /> WORKQlt1? M. LOG IN De4TF, ovilstewater)for <br /> reg Oaf orypwpom; Y <br /> CERC:LBTHR ArPROPHYATiz RESPONSE LAB SAMPLF DATE <br /> ab- <br /> SAMPLE t# 9 CLEENT 113 DESCRIVI CON MATRIX SAIYEI UED CONDITION(igI C) <br /> 1. Custody Scal(s) Pirsent Abseu `j V _ <br /> F Iui t l IIrakcttii° VY-XLU— - - <br /> 2 Chan-ok-)istod Yresen 1 Absent* <br /> 3 Traffic Repnria oI } <br /> Yacktn List Prescni A sent <br /> 4 An <br /> biD Ai bill 1 Sticker <br /> i <br /> Presext! sett , <br /> 5 Atrbill#. <br /> 6 Sant !o I.7bels r t 1 Abscnf <br /> 7 Sample IDs is l Not Listed <br /> an Ll of Glsst4rly <br /> R Sample Condition latact Flroken*1 <br /> ng# <br /> 9 Doesinfoniiattoaon <br /> custody reports,traffic <br /> _ i <br /> reports and sample _ <br /> labels agree? es No <br /> 14 Sainpio rexeivod within <br /> hold trine. s No* <br /> 11 Proper Preservntives <br /> ti sed No} <br /> 12 Tcrnp Rec at Lab, 6 `� <br /> {Aeeeptance range for samples <br /> r ur3u, thermal ros 4�1-2°C }(es I IIo} <br /> �Tf Circicel, con#act Yra'cc#1Vlana er srnd x##aclz reeazci of xcso)tttzazt. <br /> Sarnp)e Recolpi Log <br /> RimsTon21(1111OM) Page of <br /> Ruplaoes ttevlslon 2 JI IAXV0a) <br /> Effedive 1111200 <br />