Laserfiche WebLink
DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Address 71-^ N ON, ,t1; F- <br /> Geotechnica! Suppor, Se (please print) Phone No. rra 4 L Q 1"�3 <br /> �ERMITSERVICNMENTAL ALTH Pro M rJConte6 n1i2i' FLcP•t'S <br /> 10624 Olive Avenue <br /> PE(.:�fT SERVICE i• 8 <br /> Oakdale Calif. 9536193 JUN 2 ' FM ': 59 Pink-Fuld Copy <br /> (209) 847-8757 Record 1 11TID and Y9flturn t -Client L&boralvy Pilin SsmPlr <br /> D Yellor •Return Po picot <br /> P� Sti vSSS/L .¢ssf <br /> PROJECTISITE NAME: 3023 "R'TLL- ANALYSIS REQUESTED 1 <br /> F E 0-ff L_ cj n—gTe tjI &A— ti yy4 <br /> PROJECTICONTRACTIPO NO.: ` <br /> NAME OF SAMPLER: <br /> REMARKSISPECIAL INSTRUCTIONS <br /> L <br /> LAB USE ONLY AMPLE m NUMBER <br /> LAB I.D. I.D. TIME O ¢ CAN- m <br /> (a:) TAINERS <br /> t �— <br /> ' y y. lb ,� 3Q 13713$ <br /> ( ter <br /> 30 <br /> 1 <br /> 3C+ fs� <br /> RELINQUISHED BY SIGN DATEITIMMEE.�� RECEIVED BY IGN) DATErnME RECEIVED FOR LABORATORY <br /> r t C;�/` �� -/� f/�y/•!'T BY(SIGN):� DATEITIME <br /> RECEIVED: <br /> COLD AND INTACT OTHER PRESERVATIVE OYES A�: <br /> OOTHER: <br /> TURN AROUND TIME: <br /> SHIPPED VIA: OFED X 32UPS ❑OTHER: SHIPPING ORDER NO.: 021-Hr 02-Day 13"aI �1 Day <br />