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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> A y, <br /> CLI EN r NAAIE DATE Received at Lab. Sa- �d (Drinking na(er)for <br /> RhC BY (FRIlVT) L.5 TIME Received at Lab �l>.s` regulatory purposes, YESINO <br /> NVORKORDERFLfc�7LOG IN DATE. (Wastemater) for <br /> regulatory purposes- YESINO <br /> Cl BCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE 4 # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION (ETC) <br /> I Custody Sedl(s) resen Absent <br /> Intact Broken* <br /> 2 Cham-of-Custody Presen Absent* <br /> 3 Tiallic Rcports or <br /> Packing List Present/ sent <br /> 4 Aubill Airbil ticker <br /> Presen /Absent <br /> 5 Anbill V 1 4 4,55ju 2 <br /> G Sanr lc Labels se t/Absent <br /> 7 Simple IDs ist d/Not Listed <br /> on Cham-of-Custod - <br /> 8 Sample Condition &I I Broken*/ <br /> Leaking* <br /> 9 Doss information on <br /> custody reports, trafflic <br /> reports and sample VW— - z <br /> labels a reel /No" 17 <br /> IO Sample received within 13 <br /> troll brie e /No* <br /> t1 Proper Preservatives <br /> Ilset� Ye 1 No* 17 <br /> I2 temp Rec at Lab t � <br /> (Accep(ance range for samples <br /> re arra: drerrrral etes 4+/-2°C) <br /> (S)NO* <br /> Y w.hyE a3'tiG' bxit t f+x.'Hka`CS�. + 3n Y.4c r 1 ' <br /> 71 J-1 <br /> *If Circled, contact Project Manager and attach record ol resolution. <br /> Sample Recerpt Log <br /> Revrslon 2 1 (11/1oleo) <br /> Rer,laces Revision 2111/OW= ParrP �� of <br />