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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CULNT NAME: DATE Received at Lab: a (Drinking water)for <br /> l tE C. BY (PRIyrl <br /> G4 � TIME Received at Lab. regulatory purposes: YES/NO <br /> ) <br /> WORKORDER: {7 -" - LOG IN DATE. (Wastewater)for <br /> regulatory purposes: YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> 1. custuily seal(s) Present/ bsen <br /> Intact en* �. <br /> .y <br /> 2. Chaiul-of-Custoci resen /Absent* t <br /> 3, Traffic Reports or <br /> Packing list: Present/47bTa� 57 <br /> 4. Airbill: Airbill/ <br /> 5. Airbill#: <br /> 6, Sample Labels: n[/Absent <br /> 7. Sample IUs: !Not Listed <br /> . t <br /> o linin-of Custod 1 <br /> 8. Sample Cunditiot►: t /Broken* <br /> Leaking* <br /> 9, Docs infunnation on <br /> t;ustudy reports, traffic <br /> reltorls and siunple <br /> l sbcls agree? ffel No* <br /> I U. Sample rccx:ivcd within "~ <br /> hotel titnc: 1 Na* <br /> 11. Proper Preservatives <br /> F <br /> used: /No* <br /> 12, Temp Rec. at Lab: - <br /> x{AccejAance range for samples <br /> requiritig thcrn►at res.:4r!-2°C) e /No* <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Recelpt Log <br /> Revision 2.1 (11!10!00) Rage of <br /> Reolaces Revlsion 2(111)6!40) <br />