Laserfiche WebLink
SEOUOIA ANAIN I'IC AT.SAIMPLE, RLCEIP r LOG <br /> r v *^'++w. a r.•ever r�r w rr .r r . r rrrnr rm r.. - <br /> CLIENT NAME - DATE Rrlelved at Lab` � L � (Drinking water)iflr '< <br /> REC BY(PRIN 1) 1IAIF.Received at Lab. bl) regulatory purposes: YTS <br /> �VORItORIIER: ^..__s LOC IN DATE: ffitstewater)for <br /> regulatory purpDses: YI�rS <br /> CIRCLE r1,APPROPRTATE RESPONSE LAB SAMPLE DATE , <br /> SAMPLE ti N CLlEt>T ED DISCRIPTION MATRIX SAMPLED CONiyITIGN(BrC) s - <br /> L Custody Seal(s) Present Abst) - F <br /> ' Intact!H <br /> 2. Chaim-of-Custody C-1jr <br /> ]Rjt!AbSf:At4 r �-3[ <br /> I 'hMfu c keports or CAA ; <br /> Packtap,Li st. Present f bsen!- <br /> 4 Aubdl Airbdi I Sticker <br /> Present! Gst�" <br /> S Airbill H. A <br /> + 6. Sana le Labels Absent <br /> r 7_Samplo JUS 1 este I Not Listed <br /> E <br /> Qn ba�n•oF-C�xtnti <br /> S Sample CQri(titian tas mken* s <br /> 9. DDes tnf rUIRI on D11 <br /> ` custody reports,traffic , <br /> mpoTU anti samplo <br /> labels agwo? Ae* <br /> 10. Sample received withm <br /> hold time, INo* 3 <br /> I I Proper Preservatives <br /> used• NQ* <br /> 12 Temp Ree,at Lab <br /> (Acceptance range for samples <br /> r trirm tlie �l res 4+1-210 Yes I No* <br /> 46'VI\57RN -1 FINAi j <br /> f r FK <br /> *If Circled,contact I'lrejoct Manager and attach rceard of resaltt#ion. <br /> Sample-RawTpt Lucy <br /> RevisTan2 1(11110100) B_-- -- _-_af <br /> Replaces Revision 2(1110M) fl � <br /> E1Feattve ii/1000 <br />