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SAMPLE CHAIN OF CUSTODY RECORD C <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab. Analysis by <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361S, LAB. INVOICE TO <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECORD 7, OF Z PH. # ( ) <br /> CLIENT / CONSULTANT: l p v\ f ` P.O. #/ INVOICE # <br /> ANALYSIS RESTED 5 f o )r-- <br /> SITE SAMPLE MAP <br /> PROJECT SITE NAME: S-}-c\� � ��Gi C[QS (ITEMIZED AND CHE aEtow/ b. Ig <br /> J—=�— (NORTH <br /> y y <br /> Z <br /> '7 ( � f <br /> STREET: AJ ` f N N I CITY: 1^D A C STApStAMPLE <br /> �a Iw� HIP vu: S o <br /> N 62 O W J ~ <br /> AYBILL M 5 1 <br /> SAMPLER:0' BD slcNAruae) $ <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE o r wXOF (CRAROR = = s(/DRMIFIGTION) MTHIDAY/YR HOUR/MIK QTMAINERS ODMPoSTlE) X H d ¢ m m REMARKS/ SPECIAL lNSTRUCTlON51 BELOW <br /> 1XI x x T <br /> 2.) 11 I X K X Q 11 <br /> 3.) it ( x x X 11 1( <br /> 4.) 11 X X <br /> 5.) 1 S x 7C <br /> 7.) U x X X <br /> &) \1 6 X X x <br /> 9.) P - ra k -D t <br /> lot-/!y_ �/�-��96 ••SAMP/E/MEGR?)'/CONDITION 6 TURNAROUND TIM£ •• <br /> RFf-EIVED COLD k INTACT / ITS ( NO ( <br /> RELINQUISHm BY' DATE/TIME: RECEIVED BI':rsaw.rvao ATE/TIME. PRF_S F.R\'ATIV ES USED / YES ( � NO ( ) <br /> CUSTODY SEALS INTACT / YES ( NO ( NA <br /> AIR BUBBLES IN E.OA'S / YES ( No ( LINE h <br /> UISHm BI':n.:x.ruxu ATE/TIME: FEIVED 1':s�. LATE/TIME: <br /> TURNAROUND TIME: CHECK OA'F <br /> 0 <br /> RF : CISII4D B)1...�..un., IATE/1Ip14. _ <br /> BORATORI4..me m....a..nu•m )ATE/TIME (j,) 1 <br /> 1�-IIUUR ( � IB.❑t1HH ( � £-UA\ ( � ID.UA1 ( <br /> NOTE: LABORATORY SAMPLE ARCHIVING WILL BE 30 DAPS FROM THE DATE SAMPLE WAS COLLECTED, UNLESS OTHER ARRAINGEMENTS AHE MADE. <br /> PLEASE RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE . THANK VOU DEL-TECH FORM C.O.C. <br /> Pink - Field Copy White & Yellow '11, Lahunllon kith Sunlple, Yellow Return DI Chm with Rc,ult. <br />