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• 0 s _ <br /> s <br /> SEQUOIA ANALYTICAL SAMPLE ,RECEIPT LOG <br /> CLIENJ NAAJE• DATE ReL,eived at Lab. 0 (DI Inking water) for <br /> REC BY (PIUN I') TIME Retelverl at Lab. ( } � regulatory purposes VESINO <br /> 1'S'L RKORDER. VLpo LOG IN DATE. �'✓� (Wastewater) for <br /> regulatory purposes: YES/NO <br /> CIRCLE I'iIE APPROPRIATE USPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENI ID DESCRIPTION MATRLX SAMPLED CONDI1ION(ETC) <br /> I CustudI Seal(s) Present/ elt� <br /> Intact/Biokeil* <br /> 2 Cll=lln-of-CuSlod e 1 Absent* 1 <br /> 3 1 raftis Rr-ports oI <br /> P,wkii l LiSL Preseut/ tisel <br /> I AItb111 ifi/ [ �r <br /> rc r►t/Absent y ; <br /> S Altb1114 r <br /> G Sam Ilc,Labels res i 1 Absent I 's 1 <br /> 7 Samiph, IDs '9t <br /> /Not Listed <br /> on C:haln-o#-CustodyD V� \V i <br /> S Sample Colidwouilii D/Broken*/ i]Jkt}Lt <br /> -- — Leaking* <br /> 9 Dins 111fuimation on <br /> t,llsrotiy lepolLs, traffic <br /> iepolts anti sample <br /> lattels a deet / No' -� <br /> it} Sanlplr_. Icci-i%cd ait11II1 <br /> I101d time 4S No* <br /> 11 hopeI Pieseratives <br /> k <br /> tt5�t� l No* <br /> 12 `I emp Rec at Lab � _ <br /> (tW,q(allce 1,1116c.for samples <br /> Ei,uil1116, tlt:.[t11aI Vics 4 t-1-2"C) � I No* f <br /> *1r Cn cled, contact Project Maltager'and ttac'h record or resolution. <br /> Sample Receipt Loy <br /> Re ri5wn 2 1 (1 111 DIOU) <br /> [7�na nF <br />