Laserfiche WebLink
r <br /> NOV - 1 <br /> &-- <br /> S-EQUOIA ANALYTJCAL SAMPLE RECEIPT LOG NT HEALTH <br /> r <br /> TiThivii <br /> CLIENT NAME: DATE HEC'D AT LAB' '' b� For Be a ulatary Purposes? <br /> REC by(PfUNT) l7J1.r ]�rA - ---- _ TIME RECD AT LAB- I0� raRENK' YIAYER YES > <br /> WOAKORDER: vo:�-{ DATE LOGGED IN: � ����d C/ WASTEWATER YES! ti , <br /> (Far clients requlrine{xroscrvallon shenakr at rccarpt,dacunalrt here j <br /> CIRCLE THE APPROPRIATE RESPONSE LAS DASH CONTAINER PRESEAv SAMPLE DATE gi mmyts; <br /> CLIENT!D <br /> SAMPLE 3 AESCRIPTIRN ATISfE MATAIR SAfi PLED GONDRION(EIC,] <br /> I CustodySeaf(s) Prase <br /> I lBroken• <br /> 2. Cham al-Cusiod t I Absent` <br /> 3 Traffic Hapolts or If <br /> PacWhIIsi. PresenMiat <br /> 4.Alrblrt Arrb�,il!! Itcke ]I <br /> q� Absent II <br /> 5 Alrbill# ,[ I <br /> 5 Sample Labels P Il Absent I� <br /> 7. Sanip!e IDs Lyste /Not listed <br /> Do Chain-ofCusfo I� <br /> 8 S.arnplo Condition nta- l srokon'1 <br /> LeakingIr if <br /> 9. hoes information on chain-ot-cuatody, �f <br /> traffic reports and sample labels II <br /> agree? Ce l No* ]� t <br /> 10 Samp!e mcalved wilhEn rl <br /> hold Irma? l No. ][ <br /> 11 Adequate sample volume II <br /> recemed? <br /> 12 Proper Preservatives �I <br /> used? <br /> y 13 Tnp 01ank I Temp 131ank RocoivodT �( L <br /> F' I�ICIF`%%Kt6 d YC31 Yes Il <br /> 4.Temp Roe at lab. <br /> tJ, Is tamp 4 44 2°G? Ye- No's <br /> y� mm rang*iorsam0l4es requfft IhermW pies) <br /> t` coption(if any). METALS / DFl=ON ICE <br /> i i i1r pmbrem COC �� <br /> 411=CHICLED,CONTACT PROJECT MANAGER AND ATTACH RECORD OF RESOLUTION. <br /> t�Yisbn s - <br /> as Eti9r 5(Q&�710d) - Pap* <br />