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• • <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> M11 mm t ' <br /> DATERF_C'DATLAB _3-4-04, For Regulatory Purposes) <br /> L � } r DRINKING WATER <br /> YES 1� <br /> �,a�► el�er"a- LAVr-61 l� DATE LOGGED IN. 'alto o 6 WASTE WATER Ya;s No <br /> CIRCLE THE APPROPRIATE RESPONSE LAB DASD CIr1ENT ID CONTAINER PRESERV pH SAMPLE DATE REMARKS. <br /> CONnlTIONETC <br /> SAMPLE# # DESCRIPTION ATIVE MATRIX SAMPLED <br /> I <br /> 1 Custody Seals) =roken* <br /> /A <br /> 2 Chain-of-Custody n Absent* <br /> i <br /> 3 Traffic Reports or <br /> Parking List Present/ sent <br /> 4 Airbill, AErbill/Stic <br /> Present/AbeeTV <br /> 5 Airbill# P- <br /> 6 Sample Labels cpresed I Absent <br /> 7 Sample lDs Est6o Not listed <br /> on Chain-of-Custody <br /> r <br /> 8 Sample Condition act roken*/ <br /> inn * <br /> 9, Does information on chain-of-custody, <br /> traffic reports and sample label <br /> a roe? a No* <br /> 10 Sample received within <br /> hold time? yNo* <br /> 11 Adequate sample volume <br /> received? <br /> 12 Proper preservatives used?— � aJAO. <br /> f 13 Trip Blank/Temp Blank Received? <br /> " (circle which,If yes) Ye <br /> 14 Read Temp — f <br /> Corrected Temp C <br /> Is corrected temp 4+/2°C? Y41 1 0*' <br /> (Acceptance ranga for samples requiring thermal pros) <br /> "''Exception (if arty) METALS ! DFF ON ICE <br /> or Problem COC - <br /> *IF CIRCLED, CONTACT PROJECT MANAGER AND ATTACH RECORD OF RESOLUTION <br /> SRC_Revision 7 Page /of <br />