Laserfiche WebLink
SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG •K <br /> CLIENT NAME: DATE Received at Lab,� �—��'�� �(I)i Inkling n iter) for <br /> REC. BY(PRINT) TIME Received at Lab: regula(my purposes YESMO <br /> WORKORIIER• LOG IN DATE: ffas(cwatu) for <br /> regulatory purposes: YES/N0 <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DAIE <br /> SAMPLE# # CLIENT IU DESCRIPTION MATRIX SAMPLED CONDI-11ON (ETC) <br /> Custody Seal(s) Present t AU _ �* ( <br /> Intact/Brokelt* <br /> Cllaui-of Cuslod res t!Absent* 4-5 <br /> Traffic Reports or <br /> Packiu List PU,5elit{ 175 t <br /> A1rb111I S Or t�t3 <br /> _ P es t I Absent —( <br /> AllGlll# 3 25 _ „ <br /> San? le Labels l t C Absent <br /> Sample IDs d/Not Listed <br /> on Chain-of-Cuslo(l <br /> Salliple Condition broken*I <br /> Leaking* <br /> Does information on <br /> custody ieparls, traffic <br /> lepoils and sample <br /> labels agreeI 1 Nok <br /> Sample received within 1 <br /> Bald time 41 No* <br /> Proper Preservatives <br /> used e f Na'� _ <br /> Temp Stec (it Lab <br /> XLPIAnce i ange for samples <br /> titful y llie ilial 7tes-41/-2'C) talo* <br /> a i z <br /> *If C11 contact Pi oject AIallag 7 and attach Iecorti ©f resoltltio(t. <br /> Sample RRcellil I cg <br /> Re'll-'k 11 1 I tt Irtmm01 <br />