Laserfiche WebLink
f <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG LLM <br /> � µ <br /> 3 <br /> CI,IENT NAME' DATE Received at Lab: c� ,,l (Drinking water) for <br /> IZEC DY(PRINT)t) T131E Received at Lab: � 6 regulatory purposes: YES/NO <br /> WORKORDER• "3l ZOO i LOG IN DATE: 12(t r — (wastewater) for <br /> regulatory purposes YESfN0 <br /> CIRCLE THE APPROPRIATE RESPONSE LAB sA.NJ[PLEj DATE <br /> 1 <br /> SAMPLE # CLIENT ID DESCRIPTION MATRIX S ED CONDITION(ETC) <br /> 1 Custody Seal(s) res <br /> Broken o <br /> 2 Cllam-cf-Custody resen- Absent* <br /> ffi �3 <br /> 3 Trac Reports or <br /> Packing List Plesent� 0S <br /> 4 A.ttbkll Aurbill/Sticker <br /> Present l7se © ' t l <br /> 5 l�Irbf# !2' <br /> f Sample Labels Mt AbsentOq <br /> 7 Sample IDs Not Listed "ft x <br /> 0 V <br /> CltatIt-of-Custod <br /> 8 Sample CondtUon tact roketl*! <br /> Leaktrt * <br /> 9 Does Information ort <br /> custody reports, traffic <br /> f <br /> reports and sample <br /> f <br /> labels agree? a No* <br /> 10 Sample received tivttlun ' <br /> hold tulle e f No* <br /> 11 Proper pmervattves <br /> used !No* <br /> 12 Temp Rec at Lab Jam, 0 <br /> (Acceplance range for samples <br /> 11CqUITHIg tltetmal Ejes 4+1-2°C) Yes No* <br /> Ni f a+Aa/ i M i x. a a,.. l Kr✓a ^iL tx xK.p rw.t..W.h i .-www. d e i " • r• hx1^ < r[xdd . ,g ^ 'p " < <br /> *If Circled, contact Pt o'ect Manager and attach; recol d of resolution. <br /> Sample Receipt Log <br /> Revision 2 1 (11110100) Page of <br />