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} <br /> SEQUOIA <br /> ANALYTICAOAMPLE RECEIPT LOG <br /> F � w DATE Received at Lab Lf (Drinking water)for <br /> LIEN 1 NAME <br /> RTIME Received at Lab- <br /> CEC I3Y (PRINT?Fregulatory purposes. YESINO r <br /> YVQRKORDER• LOG IN DATE- G� �} (Wastewater}for <br /> regulatory purposes YES/NO r <br /> CIRCLE THE APPROPRIATE RESPONSE LAB Dash CONTAINER SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION pH MATRIX SAMPLED CONDITION(ETC.)MENWWMEEENM� g <br /> r5 w � <br /> I Custody Seal(s) Preset g <br /> Int ct/,Broken* <br /> 2 Chain-of-Custody I Absent* <br /> r <br /> 3 Anbill Airbtll 1 Stacker <br /> Present/ nn <br /> I <br /> 4 Alrbill# u <br /> S Sample Labels /Absent <br /> 6 Sample 1Ds 10/Not Listed <br /> hay n-of-Custod <br /> 4 <br /> 7 Sample Condition f&laa 1 Broken*1 <br /> Leakm * , <br /> 8 Dees inloimatcon on custody reports, <br /> traffic,reports and sample <br /> labels agree? e I No* <br /> 9 Sample ieceivt,d within <br /> hold Lime O 1 No* <br /> 10 Proper Preservatives # <br /> used ys 1 No* <br /> 11 Tem erature Blank Received? Q/No* c <br /> 12 1 emp Rec at Lab 3-L <br /> c <br /> (A(,c cptai)c.e range for samples <br /> re utrtn thertnal pms 4+1-2°C) /No* <br /> 13 Samples wlleued more <br /> titan 4 days ago r Yes*/ <br /> W Circled, contact Project Manager and attach record of resolution. <br /> Sample Recelpt Log <br /> Revision 2 2(8/30/04) page of <br /> Replaces Revision 2 1 (11110/00) FIGURE 6b <br /> Effective 911104 <br />