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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME. UPS— 6P DATE Received at Lab: I� - (Drinking water) for <br /> TIME Received at Lab: I (0`�"� regulatory purposes: YESINO , <br /> REC.BY (PRINT) (Wastewater)for <br /> WORKORDER: LOGIN DATE: �' ) <br /> regulatory purposes: YESINO <br /> j CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> 1. Custody Seal(s) Present/ bsen �"' Vj <br /> Int Bra en* <br /> r <br /> 2. Chain-of-Custodyrese Absetlt* �/�`� <br /> r 3, Traffic Reports or <br /> Pacicill List: Prese 1 bsen �{� " D ' <br /> 4, Airbill: Airbill/St i We <br /> Pres bsen <br /> 5. Airbill#: <br /> 6- Sample Labels: rese 1 Absent <br /> 7. Sample IDs: iste /Not Listed <br /> on Chain-of-Custody <br /> 8. Sample Condition: t l Broken*1 <br /> t <br /> Leaking* t <br /> 9. Does information on <br /> custody reports,traffic <br /> reports and sample <br /> labels a gee? e 1 No* <br /> 10. Sample received within <br /> hold time: e 1 No* <br /> 11. Proper Preservatives <br /> used; Ye /NO* <br /> 12. Temp Rec. at Lab: - <br /> (Acceptance range for samples <br /> e :4+/-2-C) /No* <br /> r inruz tliennal. res. <br /> ' *If Circled, contact Project Manager,and attach,record of resolution <br /> Sample Receipt Log <br /> Revision 2.1 (11110/00) i page of <br /> Replaces Revision 2(11106/00) <br />