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i • i - <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab:3 () (Drinlung water)for <br /> REC. BY(PRINT) TIME Received at Lab: t regulatory purposes. YES/NO f <br /> WORKORDER: LOG IN DATE: ) (Wastewater)for <br /> regulatory purposes: YES/NO ; <br /> CIRCLE TIIE APPROPRIATE RESPONSE LAB SAMPLE DATE n <br /> SAMPLE#/ # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> 1 Custody Seal(s) reser Absent a.Vf <br /> ntac token* <br /> 2 Clia►n-ol-Cust, se Abserit* r x <br /> 3 Traffic Reports or <br /> Packing List Present , bse t <br /> 4 A►rbill Aiibill I Sucker <br /> Present OFSenttk <br /> 5 Airbill# <br /> b Sato le Labels efr—esev Absent <br /> 7 Sample IDsListe of Listed <br /> on Cliain-of-Custody <br /> 9 Sample Cond►tion n a Broken* <br /> Leaking* TV _ 2 <br /> 9 Does information on <br /> custody reports, traffic <br /> reports and sample <br /> labels agree? eMNo* <br /> 10 Sample received within <br /> hold time 1 No* <br /> 11 Proper Preservatives <br /> used !No* <br /> 12 Temp Rec at Lab D <br /> > (Acceptance range for samples <br /> re 11inng thermal res 4f/-2°C) Yes No* <br /> H <br /> YN <br /> *If Circled, contact Project; Manager and attach record of resolution. <br /> Sample Receipt Log <br />