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• • <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIFN f NAME. DA7 E Received at Labn E'� (Drinking water)for <br /> REC HY(PR1NI) TIME Received at Lab- ) (P SC regulatory purposes' YESINO <br /> WORK01WER ? i-1 1 t7 LOG IN DATE: I I Z, (Wastewater)for <br /> regulatory purposes: YES/NO <br /> CIRCLE I I'lE APPROPRIATE RESPONSE LAB Dash CONTAINER SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION pH NIATRLY SAMPLED CONDITION(ETC) <br /> i <br /> I Custody Seals) Present 1 Adr <br /> i <br /> Intact I Broken* <br /> 2 Chain-of-Custody. e /Absent* <br /> 3 Aubill Airbill l Sticker <br /> I'tesent/ se <br /> 4 /ltrbtll It TO I I I 1-i 0 Mtao <br /> S Sam le Labels r se t!Absent <br /> b Sample IDs rst /Not Listed <br /> o ham-of-Custody <br /> 7 Sample Condtttou lir` l/Broken*1 <br /> Leaktn * <br /> 8 Does infortnatrou on custody reports, <br /> traffic,reports,and sample <br /> labels a me? I No* <br /> 9 Satnlrletecetved within <br /> 5 <br /> hold trate Y /leo* <br /> t) }'roper Press rvatives ' <br /> used L-Ves 1 No* <br /> I I Tem eratute Blank RecetveV 1 No* <br /> 12 Femp rtes at Lab z aerw c <br /> (Accept.mce range for samples <br /> teguiring theunal pies 11+1 2°C) fyjls I No* <br /> 13 Satrtiples c oliectcd mare <br /> than 14 cls 5 0Lo`f Yes� <br /> i R siih.. 41' w� � Y . k _.• w s it ,• � K l J i <br /> *If Citcled, coiitact Project NIaua ei aiid attatli tecotcl of resolutioll. <br /> Sample Amyl Log <br /> rievisloii 2 2(0130104) Page r,l <br /> nr,jifarga 11evisson 2 1 (11/1MO) FIGURE fib <br />