|
7;-P�';•►'!'l'• :fi. ,��y.j�:!�'� ;C,.,• •°�.. :�1. ... ✓' .. :i,n.,., t ]•r,C''•ric- ;.j:-'l:y -w%C 1. ,w'• `•ro• .. .t .. -
<br /> ,::C'f3i;,t[ts� s°:.,'i+•�, }.."D� .,..�w.• _�. .:...:'.•' 1�' :,p -a;;.,r... ..
<br /> �:,-'•'"' Z .. T°. •�":.di tit•'.A.!'r•r„1.y zq- v -•�._ - - �° •,..+•'• . .
<br /> ' � '4 ; G;,a _,•,brae=,:a.•='t r�.;'.;. SEQUOIA ANALYTICAL SAMPLE -RECEIPT.LOG i:.,
<br /> ,• :ter �., �,}r .V.�„. •�1tr r•r., •:i+•<!L. 'a.., .?i i�y �;z:::t•�•:�.•�'�rt`..u;F,'r,''[`T.S'.-.'.t ti� ''•� .M� —•i' fir' •,x :�: t• .:t,, .
<br /> '� a '•13�it ! .1'•1 wi s'ah:Y r,• :1 �.`,.•' .'.r,�. ?!•:+•,.. 'x'•'i•:: �.�,� .`f..
<br /> -t�rr _�.,r tt.•['✓• d'- ,},,,. �.:•'/%y.�• ,�y� �i7,,.r •, •.1�1•I'r••7t: „•��'�i., ,r •A- - ;i.i,��t ,."•,. •,
<br /> .i •.2C�• Qr•,� �•,. fr•!.t'�ir.ru '�i'•��i.�r.: s't :�• t. .•><•Vr: � �.:' r ,,�. ..,• y�s.�.:�.�•.. •r.
<br /> i:�fr: fii �'j'":.-..:�� �"�,•."�5.,_'•s:�l >. .r.. .3�. .1.. •1 •{ tl•'y,�J t, r .�s `It(�.(,•e• (•.:�y ,.:�C.]:i:� r '•r..y f•' _ •
<br /> i:�' ..k�:;.G".��3.• t� t 4t�:!:w�� •.�.:+ •,4`_:K' '�,;. ,; .t:� t r:." .:a• :t ... ., 7� a. ....••i�' ..r. .r.
<br /> = A •o. •,"rL M• •et .: e+-`v.• •�' t.
<br /> .:r M '.rsrcJr ��W:• ' 1 :r':,tx7�:r:.t2:
<br /> CLIENT:,,t�AME: �'� r .� MASTER':LOG NO.:L.PAGE.- �.
<br /> E' ".eJ ;' PRItJ.T a_. . � _ ,p...• w•�r,`DATE':OF LOG-INt. •� <;,:;;: .�: _' .
<br /> � -� mss`•' gg tr t��r, !,. }' 1 %?�' 1•• gg�•��e1 7-. .-'t:• ��.:�� ••k%}s ..uu,,r• •'• ''i •' .�•
<br /> :4:•.,f�.. "�,`.•:t:S `{t - 1.5 /'41, 7•::�t;,•:i:a'S��is,Y'Flr •:,.+..�.. .i� .� ✓,..•..:.,. :ij}..r.,,'•.:: ;ri ,r •phq„_fS::'r,: •'.�.. ,r.�,.•.
<br /> CIRCLETHEAPPROPRIATERESPONSEw `' i' `'''' ` " r
<br /> ti ;�#>''," LAB SAMPLE DASH ":; ,�,.< CLIENT. �;'�;,. CONTAINER' SAMPLE DATE RENIARKS:
<br /> i2•� w•�rr'v .�. .- r44"'Iti
<br /> ,y; ' IDENTIFICATIONDESCRIPTION MATRIX SA P. CONDITION ETC,al( 461
<br /> -Present V 1-2
<br /> ... ... y
<br /> '�'-'.= '� ,�...; ':;..:,. ,, : .. f;• Intact I Broken' ,
<br /> Custody Seal Nos::?::. •. .;.'_
<br /> 3 Chain-o(-Custod `I,v-:, res / Absent'
<br /> Records•
<br /> 4 Traffic Reports•o�{:" P
<br /> resent / se
<br /> Packing List: .`�_
<br /> 5. Airbill: ` Airbill 1 Sticker
<br /> Present ! sen
<br /> 6. Airbill No.:
<br /> 7. Sample Tags: nese ' / Absent'
<br /> Sample Tag Nos.:.--.'* ste / Not Listed
<br /> on Chain-of-Custody ' t
<br /> 8. Sample Condition:, ntac roken'/Leaking'
<br /> 9. Does information ori (7—eb1 No' .
<br /> custody-,reports; traffic
<br /> reports and sample tags agree?
<br /> 10. Proper Yes. � No .. ,
<br /> 14,Presewatfves .Used: x•.;_,;:: .,� • ,.;:;:..
<br /> 11: Date Aec. at Lab'-`t`- 1-2213
<br /> t2•:.Time Rec.' at.Lab:,' 18.3o t .
<br /> ILClrcled, contact.Project Manager and attach record of resolution „ •,:•:,;= , .. . . `
<br /> J'�_Y . ... r?-�t;'xir�;- .. :. .. 's - _ tea-:.•.•• * •» •',,..
<br /> -
<br /> Page.Fo001--:-
<br />
|