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........... SEQUOIA ANALYTICAL SAMPLE RECELOG <br /> -7w <br /> CLIENT NAME: DATE Received at Lab (Drinking water)for <br /> REC. BY(PRINT) TIME Received at Lab: <br /> regulatory purposes-, YES/NO <br /> WORKORDER: LOG IN DATE: b (Wastewater)for <br /> regulatory purposes: YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB <br /> SAMPLE DATE <br /> SAMPLE#- # CLIENT ED DESCRIPTION MATRIX SAMPED <br /> CONDITION(ETC.) <br /> <Z6jjj9a <br /> 1. Custody Seal(s) Absent <br /> 1ntad-1Nroken* <br /> 2. Chain-of-Custod r Absent" <br /> 3. Traffic Reports or <br /> Packing List: <br /> 4. Airbill: Airbill ticker <br /> Presente5�—Se <br /> S. Airbill#: <br /> 6. Sample Labels: Absent <br /> 7. Sample IDs: <rjs7!ed of Listed <br /> hain-of-Cust!?gy 5V <br /> 8. Sample Condition,, Intact Broken* <br /> Leaking* <br /> 9. Does infonnation on <br /> custody reports,traffic <br /> A <br /> reports and sample <br /> labels agree? Yes 0* <br /> 10. Sample received within <br /> hold time: <br /> (rYesNo- <br /> 11. Proper Preservatives <br /> used: nes Nq� <br /> 12. Temp Rec.at Lab: <br /> (Acceptance range for samples <br /> Lreqtdrin&thermal res..4+/-2°C) I No* <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Recelpt Log <br /> Revision 2.1 (11/10/00) <br />