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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> . DAI•F IIFC'D AT LAB: _ __ For Rcgulator� -: <br /> iCLI! NT.NAME� , _ . •rimr. nrcln'AT LAn.. DRINKING W/,,� Urposa�,. <br /> �ftec.�Y(r'rTm� P U pUn'1 L'LOGGED IN: L�4 - ._...�_. WA:i'I'L WATT~j ; f� YES <br /> 'yVORKORDR: f Nb <br /> . .�. Yt_5/MU <br /> LAS DASD CONTAINER Pi RV pH SAM ILL:: DATE... <br /> CLIENT ID• DESCRfPTION ATIVE MATRIX SAM P ED CQ �� <br /> ;CIRCLE TJ lE pppROPRJATE RESPONSE 1111111111111111 . SAMPLE# # b� �[ BA <br /> RKS; <br /> Present Ab nt <br /> 1. Custody Seals) '„ <br /> Intact/Brokon <br /> Eresp /Absent" <br /> 2 <br /> d <br /> [ . Chain-of-Cu912 • --�` <br /> 3,;Traffic Reports or P sent bsen / <br /> Packin List: _ <br /> 4 ,Airbill, Airbi Sticker <br /> re /Absent <br /> 5,'Airbill#: l Absent - <br /> Sam le Labels, rose <br /> 6' fisted/ d <br /> 7.Sample IDs: <br /> o hain-of-Cu <br /> Broken*1 <br /> S._Sample Condition: Leakin <br /> 9, .Does information on chaisn-$f-custody, <br /> ;traffic teports and samp <br /> /No* <br /> a res? - <br /> 10. Sample received within e /No* a <br /> hold time? <br /> • 11..Adequate sample volume <br /> /"No** <br /> received? * -- -_ <br /> -12, Pro er reservativas used? Ye /No <br /> 13.Trip Blank/Temp Blank Received?! <br /> (circle which,If as I <br /> 14.'Read Temp: �- <br /> corrected Temp: __-- 3INa** <br /> Is corrected temp 4+/-TC. <br /> (Accoptdnco tango for samples requiring Uiormal pros.) <br /> {*Exception(if any): METALS ! pFF ON 10E <br /> or.Problem COC +�}P CIRCLED,CONTACT PROJECT MANAGER AND ATTACH RECORD Or-RESOLUTION. <br /> Pape. �.ul <br /> SRI.Revision 7 <br /> • j Flc+rdacAs Rnv 5 In7H3lndl <br />