Laserfiche WebLink
rfy_ <br /> SEQUOIA ANALYTICAL SAMPLE-RECEIPT LOOT <br /> ' DATE RECD AT LAB For Regulatory Purposes'? <br /> CLIENT NAME, DRINKING WATER YES/QV <br /> REC.BY(PRINT) TIME RECD AT LAB �______ <br /> �j FA. j o lr DATE LAGGED IN / - 7-` �� WASTE WAFER YES Oil <br /> f <br /> WORICORDL:R. - <br /> 4 <br /> CIRCLE THE APPROPRIATE RESPONSE �B DAS}i CLIENT ID CONTAINER PRESER d pH SAMPLE DATE REMARKS <br /> SAMPLE# # DESCRIPTION AT VE MATRIX SAMPLED CONDITION(ETC) <br /> 1 CustodySeal(s) Present! bse <br /> Intact/Broken* <br /> 2 Chain-o#-Custad Preset bsert- <br /> 3 Traffic Reports or <br /> Packing List Present 4a)—7 <br /> 4 Alrblll Erbil / ticker <br /> I Absent <br /> 5 Airbill# 01 <br /> 6 Sample Labels res Absent <br /> k 7 Sample[Ds sted/ ed <br /> o haln-of-Cusko <br /> e Sample Condition ro en*1 <br /> Leaking* <br /> 9. Does information on chain-of-custody, <br /> traffic reports and sarbple la <br /> a ree? e /No* <br /> - 10 Sample received within <br /> hold time? Y /Na* <br /> 11 Adequate'sample volume <br /> received? /No <br /> 12 Pro er preservatives used? Ye o* ! <br /> 1 Tn ank l Temp Blank Receiv <br /> r oircle Ich•if es) <br /> 14 Read Temp , <br /> Corrected Temp U <br /> Is corrected temp 4+1-20C? 6 / o"" <br /> (Acceptance range/or samples roquGing thermal pros.) 4 <br /> s 'Exception (lf any) METALS / DFF ON ICE <br /> or Problem COC �. <br /> "IF CIRCL>wD,CONTACT PROJECT MANAGER AND ATTACH RECORD OF RESOLUTION. tt ] [ <br /> $RL Revision 7 page i of f <br /> PMs07/19/0`5(07/13104) 00 <br /> iS <br />