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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> M <br /> CU EN I NAME DATE Received at Lal), (l)t mVtmg water) for <br /> TIh7E Received at Lab regutatoi y purposes YESMO <br /> RLC Its' (P1tIN 1) <br /> �VOi<KOR1)ER 2 LOGIN DATE. (`'Yaste�vater) for <br /> regidatoiy purposes VES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAh1PLE DAI I <br /> SAhII'LE# # MEN t to DESCRIPTION IMATMX SAMPLED CONDI I ION (E7 C) <br /> 1 Cuslody Seal{s} Present/ bsel 1a p r <br /> Int /Broken* S <br /> Z Cham-of-Cuslody rose t/Absent* <br /> 3 'Traffic Reports or <br /> Packmg List Present 1 bsD <br /> r <br /> 4 AilIbill AIrU 111 Sticker <br /> Present/Abse <br /> 5 Atlbill4 <br /> 6 Sample Labels t!Abseqmtod § <br /> 7 Sample Ws d 1 Not L <br /> on Cham-of-C <br /> 8 Sample Condition tt t 1 Broke <br /> � Leaking* <br /> 9 Does tnfol�naltatz an <br /> i cust0dJ' reports, tt"IMC <br /> lepocts anti Sample <br /> labels a tee? Y I No* <br /> 10 Sample received,.vtthin <br /> holo hu C e 1 Na* <br /> V V i'Loper Plesetvattves <br /> used Ye 1 No" <br /> 1Z Tuih Mc al Lab �', <br /> (Aca.piance range for samples <br /> let tlllllt l Iltetlttal Iles 4112°C} e J No," <br /> G M_� <br /> „� +k n x.vi» > a fN.r �.,sL u v tr a t > A.f a d4 v C r.•edcr'w2kwtf WF5 s T t Mt+l4 K- ♦oy.� .,r h7 <br /> *i f Cit cletl, contact Pa o)ect Alauager and attach recur t! orresolution <br /> I <br /> Sam{1feR� elk�t MO not I ag of <br /> pe ,_ l i Pane ___ <br />