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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab: �-�--�� � (Drinking water)for <br /> — <br /> TIME Received-at Lali: <br /> 14'ORKURDEIt F3 LOG IN DATE: )---q T (Wastewater)for <br /> regulatory purposes: YES/ <br /> - CIRCLE TiIE APPROPRIATE RESPONSE LAB . Dash _-- CONTAINER. SAMPLE DATE <br /> SAMPLE# # CLIENT.ID DESCRIPTION pH MATRIX SAIYIPLED CONDITION(ETC.) <br /> M V07 <br /> J, Custody seal(s) Absent r <br /> n 1 Broken* <br /> 2. Chain-cif-C:ustody re /Absent* <br /> 3. Airbiil: <br /> P,rWnt/Absent -2 <br /> 4- Aitbi11#: Dj <br /> S. Sample Labels: eseI Absent w <br /> G. Sample Ills: is d/Not Listed -�rT <br /> on Chain-of-Custody -z <br /> F; <br /> 7. Sample Condillon: to• i Broken*/ - ''j <br /> ' Leakiii <br /> S, Does kil'urmation un custody reports, 3-2 <br /> traffic mpurts,and wimple Z <br /> labels agree'? /No* <br /> 9. Sample received within <br /> hold tiuie: /No* <br /> 111. Proper Preservatives �t. <br /> usLd: e /No* 115 <br /> IL Temperature Blank Received?. I 2 <br /> 12, Temp Rec-at Lab. ae ees c 1. <br /> (Acceptance range fur samples ; <br /> ret uirin g thermal pres.A+/-2°C;) /No* ✓" ' <br /> 13- SaMples collected triose <br /> tham 4 da Xs ago'! Yes */ <br /> If . . . , .. <br /> * Circled, contact Project Manager and attach record of resolution. <br /> Semple Receipt Log <br /> ilravision 2.2(e130104) <br /> Fleplaces Revision 2.1 (11110/00) Mage of <br /> t=lf:_it;vu 9:1"o l FIGURE 6b <br />