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0. <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT,LOG <br /> CLIENT NAME: ?-D DATE Received at Lab: -IL, (Drinking water) for <br /> REC. BY (PRINT) TIME Received at Lab: U t4FT <br /> regulatory purposes: YESINO <br /> WORKORDER: LOG IN DATE: (Wastewater)for <br /> regulatory purposes, YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE N' # CLIENT ID DESCRIPTION MATRIX S&"PL4D CONDITION(ETC.) <br /> I Custody Seals) Present -77- <br /> 3 VY V <br /> Intact/Bra en*- <br /> 2. Chain-of-Custody Cnese Absent* <br /> 3. Traffic Reports or <br /> Packing List: Present sen <br /> 4. Airbill: Airbill Sticker <br /> Present se <br /> 5. Airbill 4: <br /> 6. Sample Labels: <br /> /Absent <br /> 7. Sample MsiQU <br /> �stedof Listed <br /> on Chain-of-CustoqX <br /> 8. Sample Condition: Broken* <br /> Leaking* <br /> 9. Does information on <br /> Custody reports,trafFic <br /> reports and sample <br /> labels aEree; Na* <br /> 10. Sample received within <br /> hold time: No* <br /> 11. Proper Preservatives <br /> used: `&Ne No* <br /> 12, Temp Rec. at Lab, <br /> (Acceptance range for samples <br /> tquiriiig thermal res.:4+/-2°C)re U r ��—le 0C) No* <br /> .SaL <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 2.1 (11110100) <br /> Replaces Revision 2(11/06100) Page of <br />