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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG ' <br /> CLIENT NAME L� I S DATE Received at Lab: (Drialang water)for <br /> t TIME Received at Lab <br /> regulatory purposes; YESl1 <br /> REC BY(PRINT) ! <br /> r, WORKORDER, Z LOG IN DAZE: —i —a q (Wastewater)for <br /> regulatory purposes- YES/ 0 <br /> 4 <br /> CIRCLE THE APPROPRIATE RESPONSE LAS Dash CONTAINER SAMPLE DATE <br /> SAMPLE#I # CLIENT ID DESCRIPTION pH ' MATRIX SAMPLED CONDITION(ETC) <br /> I — I &Y211 N7 W <br /> { 1 Custody Seal(s) T-1P,ntNsC <br /> 2-Broken'° I -�/ <br /> 2 Cliain-of-Custod r nt/AbsenIt* q jo 2zviPr APP <br /> 3 Airbill illi Qc ' tt <br /> Oe nt 1 Absent <br /> 4 Airbill# ! <br /> 5 Sample Labels re t!Absent <br /> 6 Sample IDs i ed I Not Lis ited <br /> o Chatn-of-Custod <br /> 7 Sample Condition t l Brokeni l <br /> > <br /> Leaking <br /> ' 8 Does information on custody reports, <br /> E traffic reports,and sample <br /> a labels a ee? Y /No* ` <br /> 9 Sample received within <br /> hold time Y I Noy` <br /> 10 Proper Preservatives <br /> e used nyeI No* <br /> I I Tern erature Blank Received? /No* <br /> 12 Temp Rec at Lab !degrees c f <br /> z(Acceptance range for samples <br /> re um ig thermal pres 4+/-2°C) Y 1 No* <br /> 3 <br /> 13 Samples collected more <br /> than 4 days ago? Yes* o <br /> *If Circled, contact Pioject Manager and attach record of resolution. <br /> Samp4e Receipt Log <br /> Revision 2 2(8130!04) <br /> Replaces Revision 2 1 (11/10/00) Page_ of <br /> nf+fnR FIGURE 6b <br />