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-.t I'aLr �t ci iL.'�rCY•L•J�_.. 'fit rt• *• r - ..a.:.:w.n.. t r ..:r •_ 01 <br /> )l.a f ( i c - . . _ - , . <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> F-f!?; a 4 l`r. } mf ♦L � yr 'p1 rt ,+6:n...•�..,..�t •q�\ �•:. ..7 :'�./•:ri;�i:.,.'7 tj•♦at A. ..1!r •'�'� . ''� �A� .i�!a.:��!,.. ' `'i' . a <br /> Ylf,p aft !!!w � r� +�✓f , � , � ! ( I <br /> 11, 1 T'R•4 i t •t' y •j, 'f�SY �; t i-,1' +. +,��.(yy r <br /> k fi.Riy ��za'�c�'ie!� �,��wt`'�- ♦.. ,z + f,. !'K. - !r i + : :a�. St�('+�".,` i_44jj <br /> .� <br /> ' r - < ''�.�+'� ♦ 57 a.y t a !! { .7 n d C I ( � , t • . � I . .�• <br /> r 'r nr <br /> r� C TENSJMfAME 'ir #%MASTER; LOG, NO '/, PAGE • on �`` <br /> • t <br /> „'' .i s q•• H i <br /> �S;'✓ REC DATE:'OF LOG-IN:. + ' <br /> r,1 Y' '' ef'fi`c•R� rl'�. . . .,'T..~''SM7t13:T3�+bCtNi.� h ,P I,Ca a1y 1A�'tl,�J t 'S•�_i-7� 1.>' u�� c :.'.t �A��•."�lC �' -.. t: i. .....:. .. . <br /> rf CIRCLE THE APPROPRIATE RESPONSE+ {{��2' LAB SAMPLE DASH CLIENT , `CONTAINER' SAMPLE DATE REMARKS: . ' <br /> etiF>%i' ".,5.!,.; IDENTIFICATION” DESCRIPTION MATRIX SA P. CONDITION ETC <br /> 1 Custody Seai(s) hx. Present <br /> Broken• " 2 <br /> HL <br /> 2 Custody Seal Nos::;;;: —� <br /> 3 Chain-ot Custody;: ' res I•Absent' <br /> Records-..,.:, <br /> 4: Traffic Reports or.mPresent / se <br /> Packing List: <br /> 5. Alrbill: " 'ri r` `-'' Alrbill / Slicker <br /> Present / oii ' <br /> 6. Alrbill No,: <br /> 7. Sample Tags: ...":.: ese ' / Absent' <br /> Sample Tag Nos.:.;;; : sle / Not Listed <br /> i <br /> on Chain-of-Custody <br /> 8. Sample Condition:, ntac roken'/Leaking' <br /> 9. Does Information on,- (3�/ No- , <br /> custody reports; traffic . <br /> reports and sample tags agree? <br /> 10 Proper � . Yes. No <br /> A <br /> jyk ; r- Preseivatfves..Used " <br /> 11 Date Rec. at Labs 22 • 3' <br /> 1 + •' - <br /> 1. .'. M. 5. . fl oiA� •' `• <br /> ,x., 72..TIme Rec. at.L'ab " � �g•3t� <br /> w <br /> ♦.' ILCircled, contact.Prgtect Manager and attach record of resolution ;;•' • <br /> 1 <br /> Form SC00 _ page <br /> ._.,. <br />