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SEQUOIA ANALYTICAL SAMPLE RECEIPT LUG w� ----— <br /> ( I,1EN 1 NAME � I)A1E Received at Lab ��"���^�J� (Uthilting wate[) fn: <br /> ItLC iik (l'itllYl) <br /> ME Received at Lab Q r[.gulatut} puilmscs 1 i'SIIV<) <br /> 14'(?1tKt)Iil�l�,R '� LUG IN 1)A t K' (4V.cjlen.ifer) for <br /> regiitaluiy Irnitio5('9• "� C,SlIV(1 <br /> CIRCLE I HE APPROPRI-AT E RCSPONSS� <br /> LA fA!I21S <br /> UA1 ESAMPLE# # CLIENT. II) t)ESCIRP I IUN IA141I'LEU CON D t ION (E t t ) <br /> „ l t'u5luckti�Sc,rl(s) r rit 1 tit ,�I�t/-��. X �✓ � �f� .��i �-- <br /> nta <br /> Z ( Iiain c+t-1[cslocfy to it I Absent* - <br /> 3 Iialrc I�epurts ur M /fi-�1a25 n /lr/ _ <br /> _t'.x,l.rriK l�isl 1'resecit AGscr►t � � � ------ ----- <br /> 41 <br /> 4 Atcbcll Aiibilt l St3 ec —----- <br /> Preseiit/ bse)r t- -- --- -- <br /> 5 Atibill W <br /> b Sample L,ib Is Pres nt 1 Absent — <br /> 7 Sample lbs 1 /No[Listed <br /> on Chain-of-CusLud --- - <br /> J 8 sample Condition Nita I Broken* 1 <br /> _ <br /> Leaking* - --- <br /> 9 Does cnlounalimi on t <br /> c ustudy rcpt+ils, tragic - - - <br /> iEl}t1115,rlici e7iuple — — -�-� ---- <br /> _labels agicc 1 _ Yes I No* --to Sample rLLeived MdUR - <br /> liold I+ine Yes No" -- <br /> 1 f ef 6'tesel�'71i�'eS -�-—� <br /> riser} es No* <br /> l2 1 crop t{ec A I ab - <br /> (ALU(14,111ce c,mge loc santptes <br /> r i ric+rRi lhci ni al Ines 4 J_2°C} 1 NoR <br /> Sample Receipt Log <br /> Revisio;t7l (1iIi01Q0) Palle —-of __-- <br />