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• i <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab; (Mmking grater)for <br /> REC BY (PRINT) C-ezz-ll� TIME Received at Lab, regulatory purposes, YESM0 <br /> AVORKORIIER• LOG IN DATE- �� �r.� (Wastewater) for <br /> regulatory purposes- YES/NO <br /> CIRCLE THE APPROPRIATE j/kbseut <br /> PONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC)_' <br /> I Ciisludy Seal(s) Present X <br /> tl v <br /> 2 Chain-or-Custody Pre [/Absent" <br /> 3 Traffic Reports or 7 <br /> Packin Llst Present 1 sellt <br /> 4 Airbill Alrblll/Stt r <br /> Present/AlQt i <br /> 5 Aicbill# ? <br /> G Sample Labels Cpre t/Absent <br /> lZ <br /> 7 Sample IDs qid/Not Fasted l b <br /> on Chain-of-Custody <br /> 8 Sample Condition n ct/Broken*/ <br /> Leaking* <br /> 9 Does infonnatton on <br /> custody reports, traffic < <br /> i eports and sample <br /> labels a tee? /No* <br /> 0 Sample received within ; <br /> bold time s/No* <br /> I 1 Proper Preservatives s <br /> used s I No* <br /> t <br /> lz Temp Rec at Lab <br /> (Acceptance range for samples <br /> iulmmig lhettual trey 441-2°C) ' Sp 1 No* <br /> *If Cil sled, contact PI oject M,-litagel and attach record of s4esohiIion. <br /> Sample Rocelnf t ag <br /> fZevl�i,,,, 111 111 fllnf7l <br />