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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG , <br /> DATE RECD AT LAB: - O S For RegulatOry Purpasesl <br /> CLIENT NAME: S � (5 DRINKING WATER YES/0 <br /> TIME RECD AT LAB: <br /> RE C.BY(PRINT) �� v r WASTEWATER YES 140 <br /> WORKORDER: 140A 62&4' DAVE LOGGED IN <br /> LAB DASH CONTAINER PRESERV SAMPLE PATE REMARKS <br /> CIRCLE THE APPROPRIATE RESPONSE CLIENT ID pR CONDITION{ETC.) <br /> i 5AiJ1Pf_E# # DESCRIPTION ATIVE MATRIX SAMPLED <br /> 1 Custody Ses)(s) resen Absent <br /> roken* PZ- -V�� r <br /> 2 Chain-of-Gustores Absent+ i <br /> 3 Traffic Reports or <br /> Packing List Pr ntl bs6nt ryi` <br /> 4,Alrbill Airblll/ tipker <br /> rose /Absent <br /> 5 Airbill4P O ° ~Z <br /> 6 Sample Labels rese IAbsent <br /> 7. Sample if]s. Lista Not Listed <br /> on pain-o unto I <br /> 8 Sampld Condition. Inta Broken*/ v `6 <br /> Leaktn * w7 <br /> 9. Does information on chain-of-oustody, 2-UD4 <br /> traffic reports and sample labels r '"��`� -l)�2920t1 <br /> a ree? es No* <br /> 10 Sample received within <br /> hold time? es Na* <br /> 11 Adequate sample volume l <br /> i <br /> received? Ye 1 No' <br /> 12 Pro erresew a 1No* <br /> 18, k __iMd <br /> circle which It ) No' <br /> 1'4. Read Temp 5 ,7 1 <br /> Corrected Temp'. <br /> Is carrMM temp 4 tf-2°0? Yes l No*" <br /> 0=aptonco Tanya for samploe regolrina thormai pm.) <br /> -Exceptlon of any) METALS 1 DFF ON ICE <br /> or Problem COC <br /> *IF CIRCLED,CONTACT PROJECT MANAGER AHI}ATTACH if OF rtESaLt]TIDN. <br /> Page <br /> SAL Revision 7 , <br /> RePlaees Rev 5(07/13/04) <br />