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------- � fi � � � � I• illllllll�� ■� �i <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME WORKORDER <br /> REC BY (PR1NI) DATE OF LOG-tN 2Y 13 'Illy . <br /> CIRCLE ME APPROPRIATE RESPONSE LAB <br /> SAMPLE DASH CONTAINER SAMPLE DATE REMARKS <br /> 1 Custody Seal(s) Present /Abserfl` # CLIENT IDENTIFICATION DESCRIPTION MAI RIX SAMP CONDITION (ETC) <br /> Inlacl 1 B ken" PtdCt s �J�,1 2-6 <br /> --I I � <br /> 2 Custody Seal 11 Put in Remarks - 2 <br /> Section <br /> 3 Cham-of-Custody (Eteseli)3/Absent' <br /> 4 Traffic Reports or <br /> Packing List PresentAbsent <br /> 5 Aiibill Airbill <br /> PiesentAbsent OPD <br /> 6 Airbill # �J <br /> IGF - I <br /> 7 Sample Tags Presen Absent _z <br /> Sample Tags #s Isle Not Listed <br /> ram-of-Custody <br /> S Sample Condilioii ntay/ / Broken" 1 _S <br /> I6l Ig <br /> 9 Does informalion on <br /> custody reports, traffic <br /> reports and sample &es <br /> tags agree? No' <br /> 10 Proper Preservatives <br /> used Ye 1 No' <br /> 11 Date Rae at Lab <br /> 12 Time Rec at Lab <br /> 13 Temp Rec at Lab <br /> if Circled, contacl Project Manager and allach record of resolution l <br />