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6 <br /> V <br /> T <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab: (Drinking water)for <br /> C• B1'(P p) TIME Received at Lab: _ regulatory purposes: YES/NO <br /> WORKORDEM 2 LOG IN DATE: C 03 (Wastewater)for <br /> regulatory purposes. YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC) <br /> I Custody Seal(s) present/ se <br /> ffl�Lt <br /> 2 Cham-of-Custoct Pr nt/Absent* <br /> 3 Traffic Reports or <br /> Packing List Present 1 Abs <br /> 4 Airbill Airb:ll nbse Present/ <br /> 5 Airbill# <br /> 6 Sample Labels /Absent <br /> h 7 Sample II7s Not Listed <br /> haln-of-Custod <br /> 8 Sample Condition QWJct/Broken*/ <br /> Leaking* <br /> 4 <br /> 9 Does information on <br /> custody reports, traffic <br /> reports and sample <br /> labels agree? Q,No* <br /> 10 Sample received wxttim <br /> hold time Y /No* <br /> 11 Proper Preservatives <br /> used ' Y I No* <br /> 12 Temp Rec at Lab <br /> (Acceptance range for samples <br /> IF uzrui thermal res 4+/_2°C) 1 No* <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 21 (11/10100) <br /> Replaces Revision 2(11106/oo) Page of <br />