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i • i . <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPTLOG <br /> CLIENT NAME �— DATE Received at Lab. —1 l� (Dnalung water)for <br /> tREC. BY(PT) TIME Received at Lab, regulatory purposes. YE51N0 <br /> WORKORDER LOG IN DATE. (p Z�] (Wastewater)for <br /> regulatory purposes: YESINO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB <br /> SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> j 1 Custody Seal(s) Prese Abse t Y 2 "'7 <br /> j Intact/Bro en* <br /> 2 Chain-of-Custodyresen /Absent* <br /> 3 Traffic Reports or <br /> E <br /> Packing List Presen se t <br /> 4 Airbill Airbid I S er 2 <br /> a <br /> I Pres Abs <br /> 5 Airbill4 <br /> 6 Sample Labels Pres nt/Absent t <br /> 7 Sample IDs Lis d/Not Listed <br /> I <br /> o Chain-of Custod <br /> 8 Sample Condition teakin <br /> /Broken*/ <br /> * <br /> 9 Does information on <br /> custody reports, traffic <br /> reports and sample <br /> labels agree? es No* <br /> • 10 Sample received within <br /> Bold time ^/No' <br /> 11 Proper Preservatives I <br /> used Ye 1 No* <br /> 12 Temp Rec at Lab 7-6 <br /> (Acceptance range for samples ` <br /> 'Irequiring thermal pres 4+/-2°C) No <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 21 (11/10100) <br /> Page of <br /> Replaces Revision 2 i11l081001 <br /> ' <br />