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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME. � DATE Received at Lab, — (��- �� (Drinking water for <br /> REC BY (PILIN I) TWE Received at Lab. regulatory e <br /> I; � I iur�}ps 5 YES/N(3 <br /> WORKORRER LOG IN DATE: — `Q (Wastewater)for <br /> regidatetypurposes YESMO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB V94 <br /> SAMPLE# # CLIENT ID DESCRIPTION CONDITION(ETC) <br /> 1 cimlody Seals) Present/Ab <br /> Intact/Broken* <br /> 2 C11-1111-of-Custody I Absent* <br /> 3 Tratiic Reports or <br /> Packing List Present bsei <br /> 4 Airbtll Airtnll/Stic er <br /> Present <br /> 5 Aubitl # <br /> G Sample Labels t/Absent <br /> x <br /> 7 Sample JDs ist /Not Listed <br /> on Chain-of-Custody <br /> 8 Sample Condition I cl Broken*ngl1 <br /> * <br /> 9 Does ttlforinatioit on <br /> custody reports, traffic <br /> reports and sample <br /> labels a reee t /No* { <br /> 10 Sampte received within <br /> Bold Littre I No* <br /> II Ptoper Preservatives <br /> used 1 No* <br /> 1Z Ruip Rec at Lab <br /> { <br /> (Acce.l)tance range for samples <br /> 1cc 1111111g Illel11111 fres 441-2°C) Yes <br /> *If Cis Bled, Contact rl oject Manager and attach record of resolution. <br /> Sample-Racetrl t o9 <br /> R f-I I s c1 It 10 1)(1) <br />