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4 � , <br /> i = - <br /> i <br /> l SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME. S t)C� DATE=RECD AT LAB' �Z Za'°S For Regulatory Purposes? <br /> TIME REC'D AT LAB: � `�� DRIVING WATER Y N <br /> IREC.SY(P MT) PATE LOGGED 1N: WASTE WATER YES NO <br /> �WORKORDF.R. M 0 l.0'i 9 4 <br /> a <br /> CIRCLET14SApPROPPJATE RESPONSE LAS DASH CQNIAIT ER PRESERV SAMPLE DATE REMARKS, <br /> CLIENT!D DESC>3IPTION A7NE PR CONDrTIONC) <br /> L <br /> AMPLE# # MATRIX SAMPLED <br /> i <br /> 1 Fustody Seal(s) PrQsen Ab en <br /> InU=L/Broken' , <br /> 2 Chain-of-Custody Pres t/Absent* <br /> 3.Traffic Reports or <br /> Packinq list P ras ent 1 bs <br /> 4.'Alrblll. /Sticker <br /> I re t 1 Absent <br /> 5 Airbill1,W'7616 `t <br /> 6 Sample Labels, ent/Absent <br /> 7 Sample 113s LWd I Not Listed <br /> _ o Gharn-of-Custod ' <br /> a ,Sample Condition, l a 1 Broken*1 <br /> Leakin <br /> 9. Does information on chain-of-custody, <br /> €traffic teports and sample labels <br /> a lee? No' <br /> No <br /> I0 Sample received within <br /> hold time? 1 No* <br /> 11 Adequate sample volume <br /> w <br /> received? s o* <br /> 12 Pro er preseivatives used? 1 No* ` <br /> 13 Trip Blank/Tamp Blank Received? <br /> I(cirole which,if Yes o* f <br /> 14 Read Temp. /p " 3 •' <br /> r c <br /> .Corrected Temp 1D 3. 1 <br /> I is corrected tome 4 t/-20 ? /No"* <br /> (Amaptance range for samples requiring thermal pros) <br /> 'Exception(if any) METALS I DFF ON ICE <br /> 'or Problem COC <br /> IF CIRCLED,CONTACT PRO MANAGER AND ATTACH RECORD OV RESOLUTION. <br /> i SRL An 7 Page-44 <br />