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a <br /> i <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CL1.ENT NAME: � � DATE Received at Lab; � (Drinking water)for <br /> HEC.BY(PRINT) <br /> TIME Received at Lab: ��bn� regulatory purposes: YESlNQ <br /> WORKORDER: LOG IN DATE: (Wastewater)for <br /> regulatory purposes: YES[NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE y <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> 1. Custody Seal(s) res t I2 1 ? W <br /> •i t 1 Broken* <br /> 2. Chain-of-Custod tt I Absent* 1 <br /> 3. Traffic Reports or <br /> Packing List: Presentbse , <br /> 4. AirbilI: Airbill/Sticker <br /> Present <br /> S. Airbill#: (� <br /> 6. Sam Ie Labels: esen /Absent "7 <br /> 7• Sample IDs: iste /Not Listed <br /> A)n,Chain-of-Custody <br /> 8. Sample Condition: n t/Broken*I <br /> Leann * avr 2 <br /> 9. Does infonnation on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? es No" <br /> 10. Sample received within <br /> j bold time: I No* <br /> 11. Proper Preservatives <br /> used: e /No* <br /> 12. Temp Rec. at Lab: <br /> (Acceptance range for samples <br /> r� uirin thermal res.A+/-2°C) c /No* <br /> *If Circled, coutnet Project Manager and at ch record of resolution. <br /> Sample Receipt Log <br /> Revision 2.1 (1111(/08) <br /> Replaces Rpvi.-�nn 9 it I IM/nn) PaDe of <br />