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.rr, <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> f LIEN'l' NAI1l!: DATE Received at Lab; Orinking water)for <br /> REC. J3 (PRINT) <br /> TIME Receiveat Lab: � regulatory purposes: YES/NO <br /> 1VUt±Irt)lil)1LOG IN DATE: (Wastewater)for <br /> regulatory purposes: YES/N0 f <br /> r <br /> CIRCLE THE APPROPAIA.TE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT 11) DESCRiPTION MATRIX S MP ED CONDITION (ETC.) ` <br /> e <br /> 1. Custody Scal(s) Prese<KA 5 it 4� n# 2Aj <br /> Intact/Bro Z' <br /> 2. CIlaiiroC Caslady /Absent* . <br /> 3, Trallic Reports or <br /> Packing List: Presen bs li <br /> 4. Ailbill: rr ticker <br /> Presen /Absent � <br /> 5. Ah <br /> bill#: <br /> G. Sample Labcis: eser Absent <br /> 7, Sample IDs: iste Not Listed <br /> on iairr-of-Custod <br /> 8, sample Cundition: i1lc10E Brokear*/ <br /> Leaking* <br /> 9. Does iufunuation on <br /> C:LISEULI}' rL'pUltS, lralfiC s <br /> _4 <br /> reports and sample <br /> lc.ihcEs s rrc. /Na <br /> 10, Sample rc Quived lvilldn <br /> hold time: <br /> d; <br /> 11, Proper PiemvaIives <br /> used: Yes No* <br /> 12, Temp Ree. at Lab: <br /> Aci..s t.aitce range for samples <br /> vc(.LLiJ11-4 tllcrtI >res•A+-/-2°C) <br /> oYNo* <br /> *If Circled, contact Pro ect Manager and attach record of resolution. <br /> S-imple Receipt Cog _ <br /> Revision 2.1 {11110100) <br /> Replaces Revision 2{1 I1QG100) Page of <br />