Laserfiche WebLink
Client - <br /> DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Address 72-2 1 r' ' <br /> Geotechnical Support Services (please print) Phone No. 4 -5 <br /> Prod. Mgr.lContact �' <br /> 10624 Olive Avenue <br /> Oakdale Calif. 95361 Pink•Field Copy <br /> (209) 847-8757 Record 3—of <br /> White Return <br /> Yellow• Laboratory with Samples <br /> Yellow-Reluto Client <br /> gcrSssi G <br /> PROJECT/SITE NAME: 3D�3 'r�`(RTLL ANALYSIS REQUESTED <br /> PROJECTICONTRACTIPO NO.: <br /> NAME OF SAMPLER: �r REMARKS/SPECIAL INSTRUCTIONS <br /> LAB USE ONLY AMPLE a m NUMBER + ��✓/_ <br /> 4 OF (r Q <br /> LAB I.D. I.D. LE TIME V ccCON- <br /> TAINERS <br /> 3037 <br /> I rEA ' x.1`1 } t b 'T, 30136 <br /> I <br /> -3 V <br /> RELINQUISHED BY (SIGN)- DATEJTIME RECEIVED BY SIGN DATErTIME RECEIVED FOR LABORATORY <br /> 7 I / /��/_y� BY(SIGN): �f DATEfTIME ` <br /> RECEIVED: <br /> COLD AND INTACT OTHER PRESERVATIVE OYES XWO <br /> ❑OTHER: <br /> TURN AROUND TIME: <br /> CU100Cn vie• nccn Y -ci�fmcz mnTWF:M- RWIPPIN[s C)AnFR NO 024-Hr 02-Day 05-Day <br />