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SEQUOIA ANALYTICAL SAIW3LErRECEIPT LOG <br /> CLIEN I Nr NJE DATE Received at Lab- o{� ^� Wr►rtking�r atei) for <br /> REt' BY f PR1N 1 1 TIME Received at Lab � � regulatory purposes YES/l'O <br /> �A,ORKORDER LOG IN DATE © ffasWsate-0 for <br /> regulatory purposes: YES(I O <br /> CIRCI.F I HE APPROPRIA FE RESPONSE LA$ NO CONTAINER SAMPLE DATE � <br /> SAMPLE# # CLIENT ID DESCRIPTION pII NIATR1X SAMPLED CONDMON (EIC) <br /> AMW _4 <br /> I cusiudv 5e,11(s) e.ese4it I Absent - <br /> tit t/Broken* <br /> 2 Chain of-Custody res ut 1 A ent* MIAj " <br /> � Aub�ll s ! er <br /> P es ,t 1 Absent <br /> 5 Sample Labels /Absent <br /> G Samlile IDs ist I Na Listed <br /> un Cliam-uf-Custody <br /> 7 Sample Conihtlon eta t!Broken*! <br /> Leakm * <br /> 8 Me, Infoiniation on w%tody repurts, <br /> ltalfir,tLI)IIIN, anti sample <br /> [Libels a teed Ye 1 No* <br /> 9 S,IJII IC IMeMA wttlun <br /> hold tiutc e /No* <br /> 10 Pioprt Pteservattves <br /> used /No* <br /> t L Tenn etatuie Blank Recetvedj e tl Nu* <br /> k <br /> 12 1 en1p Rei dt Lab &g c <br /> (Acceplan(-e tonge lot sdmp[cs <br /> ic(lut M ,thetutal it,& 4+/-2"C) 'e /Not <br /> I S int I&I i ulkl ted taut[. <br /> Ilt,tit 4 LhYs a u' Yes *!lk <br /> �� LL *If Circled, contact P1OJ ct hlsttlReell andattach tecoid of resolution. <br /> =-mPlp not pipl Log <br /> I lcil-x,11 a 2OauJ04) Page -- of - -- <br /> P"PIq es I'�.c�wii� 1 tl : iL';JU} FIGURE Gb <br />