Laserfiche WebLink
ySk _ SEQUOIA ANALYTICAL SAMPLE REGEPT LOG <br /> 1p <br /> CUFNT NAMF _ ?I P DA FE REC-D A C LAa DRINKINC3 WATZR tar <br /> REC BY(PRINT) � TIME >REC'D Af LABj�~ - regulatory purposes: YES KO <br /> 1�fORKdRD1=R- <br /> Gig DATI LOG <br /> JvD IN - <br /> �....� _ ����� WASTE WATER far <br /> regulatory purposes YES 1 <br /> CiRCLT;TITS A€t>?ROPRIATE RESPONSE - LA[i DASSFI 0 COt�TAIN�f�' PRSSt t�Y Sf�Ms}LE DATE <br /> CLTI"NT ID REMARKS <br /> SAi ['I.F# # DESCRIPTION ATIVE MATRIX SAMPLED CONDITION(CTC) <br /> I. Custody S001(s) PresertT! , Q <br /> IntactI broken* - <br /> 2 C'.haln-cf-Custody esen Abserl <br /> 3 Trane Reparts8r - -- <br /> Packing List Present J 5 <br /> 4 lurbllL AirJa3il ti er � - <br /> Pres Abs _ <br /> 5 ATrbill-fi - <br /> 6. Sant !e Labels Absent _ — <br /> 7. sample Ips * eD I Not Listed <br /> an Chain-of-Custody , _ <br /> 8. Sample Condition: 1t a Broken*1 <br /> Leakan ` <br /> 9. Ones information on <br /> ehafn-of-custody,(rafflc - <br /> reports and saniple ' <br /> labels agree? <br /> 10 Sample€ecefred within - <br /> hold time s I No' '� - _ <br /> 1 S_ Ade€lual sample va�ume00, <br /> received! - <br /> 12 Proper Preservatives- <br /> - _used- I N - <br /> 13. Temp Rec at Lab �-- <br /> Is temp d+I--2°C7 No•= <br /> (ACooplamp range for san7plesrequiring 11)ermeI pies) <br /> A&E:&eption(1 any) ME.rALS I DFF QN ICE <br /> or Problem COC <br /> SRL rvdAIR *IF CIRCLED, CONTACY PROJECT MANAGER AND ATTACH RECORD OF-RESOLUTION. <br /> ��visKln d�S1�IOJ'03}- - — <br /> res Rewig!op 3 to3�]at0�) Page <br />