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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> • FREC. <br /> . I t 1 <br /> DATE REC'D AT LAB; M�-� For neguiatory purposes? <br /> IT) ( — TIME REC'U AT LAB, � DRINKING WATER YES <br /> . ? aoS` DATe LOGGED IN: <br /> WASTE WATER YESd <br /> (Ear cuems sequrring preservation checks et racekpt,document he e4) <br /> CIRCLE THE APPROPRIATE RESPONSE DASIi CONTAINER PRESERV pH SAMPLE ()ATE REMARKS. <br /> ISALAB <br /> MPLE rM CLlf;1�17fD 1DF3MrPinoN ATI1fE <br /> MATRIX SAMPLED CONDITION(ETC. <br /> #_ custody Straf(s) Prase f�[ <br /> Intact f Broken" <br /> 2 Chairs-of-Cuss so t#Af serrt� <br /> 3 Traffic Reporks or <br /> f aGkin Lrst' proSanl <br /> 4• Altbifl Alrbi[I tt ; <br /> ese Absent <br /> 5 Ailbrff� <br /> 6 Sam !e <br /> p I-+16tt1$ <br /> i�r tlAbsent r <br /> e (� <br /> 7_ Sample II?s t 1 Not— <br /> Listed-on Chain-of-Cust i7 3 <br /> 8. 5amp'o Gondrtrof) InT�c !Broken'! ; <br /> ie�ktn ' <br /> 9, Does Information on chain-of-custody, i <br /> traffic resorts and sample Iabals <br /> agree? f No. <br /> 10 Sample received within <br /> hold tirne? <br /> I I Adequate sample Vorume <br /> received? - <br /> 12 ProperPreservanves <br /> Used? Y S I No' <br /> 13 Top tltank1Temp f3Wk Received? <br /> (cirda which,d es) Yes • 1 <br /> f4 Tomp Ree at Lab •, e- <br /> Is temp 4+1--2°C? s No•* <br /> f <br /> {Aa'.epLvwa mrtigo far srimplss requkukj thesmeprea,)- <br /> "Exception(if any)- METALS I DI=F ON ICE t <br /> tic Problem COC <br /> 'IF CIRCLED,CONTACT PROJECT MANAGER AND ATTACH RECORD OF RESOLUTION. <br /> :x <br /> �E RmIsTnoi s <br /> �.}o"•Slnaln7ara1 <br /> S P040 <br /> A. of <br />