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• 0 <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab: (Drinking water)for <br /> EC. BY(PRINT) TIME Received at Lab: I regulatory purposes: YESINO <br /> WORKORDER: Q LOG IN DATE,. <br /> (Wastewater) for <br /> regulatory purposes, YESINO <br /> CIRCLE THE APPROPRIATE RESPONSE LAD <br /> SAMPLE DATE <br /> SAMPLE <br /> # 9 <br /> CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION (ETC.) <br /> -- - <br /> TC;1191; <br /> 1. Custody Seal(s) Pres Abse <br /> 4�( 4 <br /> e <br /> Wtav�/ ro en* <br /> 2. Chain-of-Custody /Absent* <br /> 3. Traffic Reports or <br /> Packing List: Present bs <br /> 4, Airbill: Airbill l Sticker <br /> T Present AQt <br /> 5. Airbill <br /> 6. Sample Labels: e t Absent <br /> 7. Sample IDs' is /Not Listed <br /> on Chain-of-Custody -loo <br /> 8, Sample Condition: /I&t Broken- I <br /> Leaking* <br /> 9. Does inforniaLion on <br /> Z"I <br /> custody reports, traffic <br /> reports and sample <br /> labels agree'? No* <br /> 10. Sample received withirl <br /> hold time: /Q/No* <br /> 11, Proper Preservatives <br /> used: No' <br /> 12, Temp Rec. at Lab: L-----------I-- <br /> (Acceptance range for samples <br /> 'eqUiring thermal res.:4+/-2°C) Yes <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision Ill 0100) <br /> Page Of. <br />