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i <br /> SEQUOIA ANALYTICAL SAINIPLE RECT FF LOG <br /> + <br /> CUENT NAME:'A r DATErltecelved at arab' D (Drinlrutg ivRfcr)for <br /> RFC; BY(PRINT) TEAR 1Crceived at Lab, iegulatory purposes <br /> WORKORDFR LOC IN DATF. Nut (Wadetiwstet) far <br /> regulatory pai poses. <br /> cinci.RTHE APFROPl1LA1ERTSPONSF. LAli SAI%IP1.l= DALE <br /> SA}IP)S st 1t CI,LFNT all DF:90UPTION MATRIX SAhiPLHO CONDITION(L"I'C.) <br /> 1 custody SnI(4) Presea A sc OA W S \LW <br /> r <br /> IntaetlLlro ens .,,�� I� <br /> 2 Citaiii-of-Custodyr sc f Absem" <br /> 3 Trnl3ic Reports or <br /> Packiny,i iyt` Presentl sei <br /> 4 Aubill Asrb1111 Suc'cr 1 <br /> I Prese�it f set <br /> 5 Airbill# <br /> 6 Sam It Labels r nt!Absent <br /> 7 S.1111ple Ws is f Not 113tLd <br /> ott C1L3in-0f-Ct1Stody <br /> f S Sample Condi#toil- ntac f Broken*I <br /> 9. Does information oil <br /> F c ustud) rCPW5,I alllc <br /> reparts and sample <br /> Inbels agree? es Na' <br /> 10- Sample recened willuo <br /> hold time_ c f No* <br /> i <br /> I t Proper Pfeaerwatsves <br /> used <br /> 12 1'emp Rec of Lab: � <br /> i (Acceptaitro rmige for samples <br /> requirinthermal res 4+1-21Q Yc�l No* <br /> *If Cil sled.tout.-lct Ploject Manager and RURCxt record of t cso]ut On. <br /> $ample Reeeipt Lag <br /> Revision x i(ItffUlibD} - Page of <br /> RcWmftev:sion2(l ifl0(3+b4) <br /> m1w • <br /> rrr 11112100 <br />