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i • <br /> SEQUOIA ANALY'T'ICAL SAMPLE RECEIPT LOG ' <br /> 71 11 <br /> CLIEN I NAME- DATE Received at Lab: Z- o/0'i (Drinking water)for <br /> a if TIME Received at Lab. L: regulatory purposes- YES1N0 <br /> REC BY(PRINT) <br /> c LOG IN DATE L (Wastewater)for x <br /> WORKORDER Z C .a <br /> s regulatory purposes; YES/NO x <br /> CIRCLE THE APPROPRIATE RESPONSE LAB Dash CONTAINER SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION pH MATRIX SAMPLED CONDITION(ETC.) <br /> I Custody Seal(s) Present 1 A en '- <br /> ln Broken* <br /> 2 Chant-of-Custod se 1 Absent* <br /> 3 Airbill Airbill f Stacker i^V1 , ' Sclw e hiiJ 1 <br /> i <br /> Present lxrslen r <br /> 4 Atrbtll# <br /> 5 Sample Labels eW I Absent 1 <br /> 6 Sample lDs ist 1 Not Listed <br /> on Chain-of-CustodLA <br /> 7 Sample Conditionntac Broken' 1 <br /> En * �Min lzq -2 i 5 <br /> a <br /> 8 Does information on custody reports, - - --- <br /> traffic reports,and sample s" <br /> c <br /> labels a ee� e`s�No* <br /> i <br /> 9 Sample received within <br /> hold time hY /1 No* <br /> 4 <br /> 10 Proper Preservatives <br /> s <br /> s <br /> used 1 0* <br /> r <br /> 11 1 ens erature Blank Received? c <br /> 12 Temp Ree at Lab 0 <br /> (Acceptance range for samples <br /> !aullrtng theiinal ies 4+1-2°C) s No* _L <br /> 13 Samples collected inose { <br /> than 4 dais aQUj YeLs / t <br /> y <br /> ^If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 2 2(9194104) Page of <br /> Replaces Revision 2 1 (11110/00) FIGURE 6b � <br /> Fite(live 91 I T4 <br />