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SEQUOIA ANALYTICAL SAMPLE ACU( RECEIPT LOG <br /> k,.�.�.�r5<u���:�•����t�����-�,���f��a- :.pti��x,���t�.���,�;..•�•�t�a�-,�»� �.•�>z.�;�RA��,,. �. - <br /> C � <br /> ,d .. -•� �E"?��`�. -X111 - -- ' <br /> j C[_IGNT NAME: - <br /> I �mras+*Kx�ro <br /> r _ ___ ,1_� __ �_ DATE RECD AT LAB: ^_t t ^� For Regulatory Purposes? i <br /> IREC. BY(PRINT) .,___ ____ % TIME R'EC'D'AT LAB: _ DRIIZIKWG WATER YES/ <br /> WORKORDER: `Y` P!/1 �/� DATE LOGGED IN: M� 6 WASTE WATER YCS� <br /> �CiRCI.I_THE APPROPRIATE RESPONSE <br /> EAR [DASH'. - 1 <br /> JCLIENT ID. CONTAINER PRESF_RV S .. PLE DATE•.. �^ REM <br /> SAMPLE# # DESCRIPTION ATIVE pH <br /> A"CRIX SAMPLED -CONDITION(E-TC.) r <br /> t 1.ICustody S.eal(s) Prgsent <br /> ` ? <br /> Intact/Broken* <br /> ?_._Chain-of-Custod�T (Pre3eiB/Absent* <br /> t 3.iTraffic Reports or - <br /> •_ Packing List:_ t' sent <br /> 4.;Airbill: Airbi Vticker f <br /> -- _ res /Absent <br /> 5.4 <br /> '6rbill ( <br /> G. Simple.Labels: rose /Absent <br /> 7. Sample EDs: _fisted/ -L-i d - <br /> _- �o haln-of-Cu. <br /> a 8.:Sample Condition: Broken* µ- <br /> - Leaking <br /> 9. -Does information on chain-of-custody, ---- --- <br /> traffio tepot is and satttpla la)maq <br /> 10. Sample'received within <br /> hold time? _ (o /No* <br /> 11.Adequate sample volume <br /> receives T ^/No* _ __ ___�- -� - -•_._ - _ <br /> 12, Proper rosery (fives used? Ye _/-No* `- -- ------ -.,- <br /> 13. frip Blank/Telnp Blank Received? !N - - --' <br /> _(circle which est Yes o* <br /> f f 4.'Read Temp: _ �1 _ — __.� �... ___• <br /> 4 Corrected Temp: 4 r <br /> Is corrected tomp 4•i-/-2°C? /No** --- — <br /> (Acceptance ranee for samples requiring thermal pros.) T <br /> '"Exception(if any): METALS / DFF ON ICF <br /> or Probldm COC - <br /> ii +7'i i iifi�rinm c m;h i�wue;e ffitiaactie� isifrsttt7>iJ+ s t ri7Sa�?r+Y�nY ettirt� �sn�+f i i?::C�l b v s viii?t sasFt,a.k 3riL:�T- 3 ti';&-mr. a�xti=a:"+vt429smiAw,,! n�sF!e:y a�ieiv ax ra ;nrt S+�xs�« iV-:sem. +i�X i s a <br /> .x---•y s ...uY <br /> . *1F CIRCLED,CONTACT PROJECT MANAGER AND ATTACH RECORD OF RESOLUTION. <br /> 1 <br /> SRL Revision 7 ` <br /> I Replaces Rev 5(07/13/04) ('ago, of T <br />