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--ANALYTICAL REQUEST/SAMPLOCHAIN OF CUSTODY-- LAB.TRACKING #: - - <br /> N RECORD OF A— DATE RECIEVED: -------.--.---------_..__.__ <br /> LAB.INVOICE TO -- .�.�. __ Y.1. 1a ec1'_ n <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES /���'+� <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ��.. q3----- L-�•�►d y- Ts .... A--------------------- -- <br /> OFFICE-(209)847-8757 PH.# _`•1--t- !QS-q�.1 , Ef <br /> FAX •(209)847-7744 -j CONTACT: -- --Y__. .. <br /> ......---_.............. .................... <br /> CALIFORNIA CONTRACTORS LICENSE(16573661 CLASS"A"ENGINEERING <br /> OB# ------------_--------INVOICE#----- ----------------------------------------- <br /> II!, V€S{ €€ V "ti LAB.ANALYSIS REQUESTED NG MAP <br /> „ `il SITE SAMPLI <br /> CLIENT:k_n%,-jjCONSULTANT: Yl <br /> SITE NAME: PROJECT: T <br /> ADDRESS cm 11! ST.: 013 O <br /> SAMPLER SIGNATURE ' F C O p <br /> d N N O <br /> C� Ia pp ;D io 00 <br /> SHIPPED VIA: W II L#: pC cc��11 d d C$ <br /> ANALYSISBY• I TURNAROUND TIME: DAYS �* i- W w aP10 W m <br /> SAMPLE LD. ATE TIME CONTAINERS TYPE MATRIX (V ii "i iii is REMARKS/LAB.LD. <br /> - e 3 2ZA <br /> 2) zzt� <br /> 4.) <br /> 5.) <br /> N 3 0 tz-( . <br /> �) � 'Jp, <br /> e. <br /> ) <br /> t <br /> 9.) <br /> 34.) NN 12.) <br /> 14.) <br /> 15.) <br /> RELINOUISHEDBY: r 2 Z SAMPLElNTECRI(s10NA7uRE1 T CEfVED COLAbt INTACT ! Y8DATEITIME DATEITVAERFLGIQ[11sF{EAH1". R�I�BY: ABR BUBBLES IN V.O.A.'S I YESI (SiGNATUREI / CUSTOpY SEALS INTACT !YE5 <br /> A 1 ILML DATE I TIME <br /> RFI.INQISISIIF➢11Y_ Rrgrygpgy; PR1?SFStVATIVESUSED J Y1;5 NO <br /> I (S)GNATURE) 1 _�JUEOPE95kFEVAIIXE(Sil vt L= J <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. * (M.T.B.E.,T.A.M.E..E.T.B.E.,D.LP.E.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN TITS FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PINK.FIELD COPT' WHITE K YELLOW-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DEL-TECH C.O.C.FORM 99 <br /> i <br />