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i <br /> I <br /> ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY.. LAB.TRACKING #: L-1-L-}- - <br /> RECORD OF DATE RECIE'VED: -----------------__-....- <br /> LAB.INVOICE TO: --.1---d—T.A ��..6_.9.��-r'_� g........................-..... <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVE OAKDAL CA.95361 19 --P ..._c 1. <br /> OFFICE.(209)847-8757 LvAp <br /> FAX -(209)847.7144 1 PH.# 2" L-I O i 31 CONTACT: Z'YY .&r _B GiA----------- <br /> CALIFORNIA <br /> -- -----CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> OB# INVOICTE#..-.....---._..._.._.._ •O ------ -�...—.......... ........ <br /> LAANALYSIS REQUESTED SITE SAMPLING MAP <br /> B. <br /> CLIENT: lT0 CONSULTANT: O-vT 1 L1.:,, !9 4 W 4^11 —mr," <br /> SM NAME-&"\Nrz taROJECT: � �C�R. <br /> ADDRESS: I W lim CITY: ST, <br /> SAMYLERSIGNATURE: QbIbAl LI C e °I I~ e e 1Ttiuu3 <br /> SHIPPED VIA: WAYBILL <br /> ANALYSIS BY: TURNAROUND TPM- S <br /> 1gilt, V DAY <br /> SAMPLE I.D./ DATE TIME CONTAINERS TYPE MATRIX ":., Hill. ,3I.1, ;+, ...1 .,i ,l '".iii 'iil! REMARKS/LAB.LD. <br /> 3) � a <br /> 4.) rktm <br /> jrJcQ35`� <br /> s.) V � <br /> IVER <br /> 6.) <br /> i <br /> I <br /> 9.) <br /> 10.) <br /> 12.) <br /> 13.) <br /> 14,) <br /> I <br /> RE.a+OLIk%MBY: �p �'� �� RE�rvEnes: �n - LE INTEGRITY CONDITION <br /> (s]C3TL47UREI RECEIVED COLD&INTACT !YES ( NO ( ) <br /> rrrxnvQwss�nBY, r- RECEIVEIIBY:, - ,� AIR BUBBLES INV.O.A.S I YES NO f✓ LI 5 R- <br /> llSllt (s ki I CUSTODY SEALS INTACT ) YES NO N!A f i <br /> DATEIT E <br /> RMNQUISIEeY: R*COVE+BY: PRESERVATIVES USED I YES Lff NO <br /> iSPONATVr (SOOKATURF) r <br /> NOTE: PIJWCHIVE THE SAMPLES SUBMTT7ED FOR THE FULL HOLDING TIME ALLOWED,UNLESS GTWR�ENTSARE MADE. * (M.T.B.E.,T.A.M.E.,E.T.B.E.,19E.,T.B.A.) <br /> B.B.= BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECT FIELD. <br /> PINK-FIELD COPY WHITE&YELLOW-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DEGTBCII C.O.C.FORM 98 <br />