Laserfiche WebLink
0 0 0 <br /> _ ` f SEQUOIA ANALYTICAL SARPLE RECEIPT LOG <br /> CLIENT NAME- DATE Received at Lab- 4 (Drinking water)for <br /> RLC BY(PRINT) `I'INIE Received at Lab: d 3( regulatory purposes: Y.S 0 ! <br /> l WORKORDER LOG IN DATE: (Wastewater)for <br /> regulatory purposes- YE 0 <br /> x CIRCLE THE APPROPRIATE RESPONSE LAB Dash CONTAINER SAMPLE DATE <br /> SAMPLE# # CLIENTID DESCRIPTION PH MAtRIX SAMPLED CONDITION(ETC.) <br /> I Custody Seal(s) ql�.Dse. Absent <br /> 1 n Broken* , <br /> 2 Cbatn-ai Custod resent Absent*• <br /> 3 Airbill Aabdl/Sticker <br /> Present 1 s n <br /> 14 Airbill# <br /> 5 Sample Lhbels Pre Absent <br /> ti Sample IDs. t /Not Listed ' <br /> 1 0 Chain-of-Custody <br /> 7 Sample Condition t t/Broken*l <br /> 3 <br /> ' <br /> Leaking* <br /> 8 Does information on custody reports, <br /> # traffic reports,and sample <br /> labels a ice? Y /No* <br /> ' 9 Sample 14ceived Within <br /> I hold time � <br /> /No* ; <br /> y l0 Proper Peeservatives <br /> Iused Y /NO* <br /> 11 Tenn erakure Blank Rccerved7 es 1 No* <br /> 112 Temp Ree at Lab aegwes c l <br /> I(Acceptance range for samples <br /> requiringc9quiring thermal ptes 4+/-2°C Q No* <br /> i3 Samples collected more <br /> than 4 days u ov Yes V 0 <br /> ale Rece4pt tog *If Cjrcl4d, coartact Pt 0jeet Manager and attach recdi d bf resolution. <br /> ",n 2 2(8130104) <br /> A Revlse0112 1 (1 Vi 0/00) Page of <br /> 1/04 FIGURE [ib <br />