Laserfiche WebLink
• �� 0 <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> DATE Received at Lab: (Drinking water)for <br /> CLIENT NAME: — OV <br /> 12H <br /> REC.11Y(PRINT) TIME Received at Lab: I At regulatory purposes: YES/NO <br /> WORKORDER- LOG IN DATE: i (Wastewater)for <br /> regulatory purposes: YESINO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE I DATE <br /> SAMPLE N If CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC,) <br /> 1. Custody Seal(s) Poes it/Absent <br /> 6tt Broken* <br /> 2. Chain-of-Custody Absent* <br /> 3. Traffic Reports or <br /> CbPackPresent/im List: j�nt <br /> 4. Airbill: Airbiil/ Sticker <br /> Present <br /> 5. Airbili#: <br /> 6. Sate ple Labels: 41: Absent <br /> IL <br /> 7. Sample IDs: Not Listed <br /> on Chain-of-Cus.tody <br /> S. Sample Condition: t/B ok -1 4,. .— EEsv V I Pew I(L— <br /> taking* <br /> 9. Does information on <br /> cuslody reports, traffic <br /> reports and sample <br /> labels arce? ffe 1 No <br /> Sample received A--itlii n <br /> hold lime. No* <br /> f <br /> 11. Proper Preservatives <br /> used: ez <br /> C- s/No* <br /> 12, Tenip Rec. at Lab- -0 <br /> (Acceplance.range for samples <br /> I <br /> rrc uiring thermal res.:4-�/-2°C) No <br /> *if Circled, contact Project Manager mid attach record of resolution. <br /> Sampie Receipt Log <br /> Revision 2.1 (11110100) Page of <br /> Replaces Revision 2(11106100) of <br />