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i � i <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME- DATE Received at Lab: (Winking water)fo'r <br /> REC. BY (PRINT) TEWE Received at Lab. regulatory purposes: YES/NO <br /> WORKORDER: LOG IN DATE: fi (Wastewater)for <br /> regulatory purposes: YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMTLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC) <br /> 1, Custody Seal(s) Present Awed 1 e- ---T-M lug Sa —,�JATv lHe- <br /> Intact I Broken* A-7 <br /> J-11 <br /> 2. Chain-of-Cuss my R en Absent* <br /> 3. Traffic Reports or <br /> Packing List: PreMnt Alat <br /> 4. Airbill: 1ga�p <br /> _Glt Absent <br /> 5. Airbill-4: :R3.3 0 ctj k-y <br /> 6. Sample Labels: Absent <br /> 7. Sample IDs: Not Listed <br /> on Chain-of-Custody <br /> 8. Sample Condition, Broken* <br /> Leaking* <br /> 9. Does information on <br /> custody reports, traffic <br /> Of <br /> reports and sample <br /> labels a&ree? No* <br /> 10. Sample received within <br /> hold time: 1 No* <br /> 11. Proper Preservatives <br /> used: \,Sts I No* <br /> 12. Temp Rec, at Lab: <br /> (Acceptance range for samples <br /> virin&thermal gres,:4+/-21Q yes <br /> . <br /> Sample Receipt Log *If Circled, contact Project and attach record of resolution. <br /> Revision 2.1 (11/10/00) <br /> Replaces Revision 2(1 b 1/06M) Page-of <br />