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i • i . � <br /> SEQUOIA. ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAIVE. DAI E Received at Lab (Drinking water) for <br /> IIEG� BY (PilitV TIME Received at Lab: regulatory purposes YES/NO <br /> LOG IN DATE, (Wastewater) for <br /> W O RK01W ER <br /> regulatory purposes, YE5IN0 <br /> I ' <br /> CIRCLL I HE APPROPRIATE RE,ESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX S M LEU CONllI1l01`[(ETC) <br /> I Custody Se,ll(s) Pre ent <br /> Int Broken <br /> 2 Chain-of-Custod res t Absent" i C <br /> 3 11 Iffic ltepolts or 2— <br /> Packing <br /> Pickin Lest Piesei bs <br /> 4 Anbill Airbill/Slicker 14 <br /> Presen Absen <br /> 5 Aubill # <br /> G Sample Labels I Absent <br /> 7 Sample IDsisle Not Listed <br /> on Chain-of-Custod <br /> f <br /> 8 Sample Conditionuta Broken* / <br /> Leaking* <br /> 9 Does mformatiott on <br /> c nstody iepoe ts, traffic <br /> lepoits and sample <br /> labels a i ec l es No* <br /> t0 Sample received within <br /> lloftl(tme es No* <br /> 11 Proper PrCSCCVatIves <br /> used Ye /No* <br /> 12 remp Rec at Lab <br /> (Acceptance range for samples <br /> 1 C <br /> 1111111, th£Imaf lies 414-VC) Y 1 No* <br /> ,µad .. v lu m +Y W pDr 5+ro a&w 2 v..9a ..ro.Fu 9 f.a,e xv➢h 5�-vxat� <br /> *If Cncled, cofatact Pl o,ect Manage] and attach t ecord of resolution <br /> Sample Receipt Log <br /> Revision 2 1 (11/10/00) Page Of <br /> 1<,111 U,11LV0011 2(11/0e100) <br /> i i I 1 1 i'M <br />