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ANALYTICAL REQUEST%SAM LE CHAIN OF CUSTODY- ­ LAB. <br /> TRACKING ' <br /> RECORD OF DwTE REciEVED <br /> INVOICE TO .. ia . <br /> r r L �&EliFk: <br /> _ HNiCAL SUPPORT SERV <br /> �. <br /> �x <br /> DEL .TECH GEOTEC <br /> ICES_ - •� r� <br /> _ 10624 OLIVE AVENUE,OAKDAIA CA.95361. - Y, Am_ �._, <br /> OFFICE-{2fl9)647-S75T _ '':;- " _ ,Ke`= <br /> FAX -{209}6n-Tr4a _ P'H.# ( 3 b � CONTACT s <br /> CALIFORNIACONTRACTORSLICENSE AEr657366!CLASS"A"ENGINEERING _ . _ - :: •-�a# =y m -r- <br /> - OB II I O M 0: = <br /> uFs1�n' SAMPLING MAP' r „=; <br /> III'I!!i;,ilE€ i! iilulli� I:;hll;.l!!Illi !'ll�!;�h !i !I 1��II!!�!III!li'!�. }!I I Il,illlilll!li 1 I:�!!ifil ►�!�I!,1;1 ;11,��3 ll�l3.,!,11{}j blit�E!!€!u�,� ;II ,I: IIf1���1� :,i J,�,i„1, r�a�NALvs RFS _- z SITE <br /> CLIENT: :L•= CONSULTANT: �1.► z ,,;; :y r `, y : <br /> SITE NAME: 8 OJECFc �- - <br /> _ a.tYFi- <br /> ' ADDRESS: CRY: STS y C ori i ..L t E x <br /> t SAMPLER SIGNATURE: _ <br /> ` t. <br /> SHIPPED VIA: WAYBILL#-. < <br /> * -ANALYSIS$Y: x TURNAROUND TIME:- {7 OAY �- Td rG - `mF ,�Y�Iy1 1G '`'- 'f i.3 r'•,l� '" M:_., <br /> I` i <br /> f <br /> SAMPYBLD.! DATE TIME CON1AlNI?RS SYPH ]Sl.4TRfX :111!11 .9#1111 'III III !II!i i itIII!I II!!II!I !i!I ! !!lilll 41!1!1 `,!Ji REMARKS-/LAB.ID <br /> rr bi <br /> 2 <br /> - P ,(t•X1`7 ` - • <br /> Vic. <br /> -r. <br /> b <br /> -73i>-' - <br /> 4 <br /> : . m <br /> 14.) <br /> • DA ! <br /> RL BY: LE IN C !GOND <br /> RUMOUO-DBY: ±D -t+ <br /> yet <br /> 1 (S1U(UTS1Lti� RECEIVED COLD&INTACT! YRS NO <br /> j f _ - n ! <br /> RFI.BSQtl(SiF6DBY; r _ BY: ; �_ - _r� ? AIR BUBBLES INV.O.A.'S !YES NO LI M- <br /> W ?-S' CUSTODY SEALS INTACT !YES NO N!A <br /> _ - DALE f 7A4B <br /> RII.QiQU[SFQ•A BY: R&(EIVM BY: PRPSERVATNES USED ! YES NO <br /> - ! (SIGNATURE) <br /> NGM: PLEASE ARCHIVE THE SAMPLES SUBMITTED FORTHE PULL HMDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE * (M.T9 E.,T A.M.E,E.T B E..D.I.P.E,T.B A.} <br /> B.B.=BAILER BLANKS COLLECTED IN TIE FIELD. F.B.=FIELD BLANKS COLL.EC7 ED IN THE FIELD. <br /> PINK-FIELD COPY WHITE lQ YELLOW-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DEL-TECH C.O.C.FORM 98 <br />