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0 0 SAMPLE CHAIN A CUSTODY RECORD) 0 <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab.4� Analysis by <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 LAB INVOICE TO T1J L•, <br /> OFFICE (209)847-8757 <br /> FAX (209) 847-7744 ECORD OF PH #(� ) <br /> CLIENT / CONSULTANT: V61m 5 ! -�LL P O. #/INVOICE # <br /> ' -� � �' ANALYSIS REQUESTED SITE SAMPLE MAP <br /> nvr rv:uw <br /> 77 + (rTEMITED AND CHECA'ED BELOW) t(NORTH) <br /> PROJECT l SITE NAME VAm j mi L�.l�i, ` <br /> U <br /> uj z (n <br /> 2 a cc <br /> dg? < <br /> o <br /> STREET CITY- STATEW � Q <br /> o <br /> j� o �_ o f0 Lu <br /> O w w <br /> �, �I{1P VIA o x ¢ a N <br /> C-4 Lu <br /> SAMPLER.DslctvATpRs) WAYBILL# 92 o,5 m o = cr <br /> C7 C] r GOC tll 4 �- x EfJ <br /> SAMPLE LOCATION DATE TOME NUMBER TYPE S,gMp� i Iz uj <br /> a x o Q � <br /> (meNUArCATION) AlT6JDAE7IZ H�oultrMrN Q]NTAINERs aovrosrrs i AL4TRIX H E- m Co m w REMARKS/* SPECIAL INSTRUCTIONS BELOW <br /> 1) mow- 2411>1V IllS UA-9 "%TEF-x uErc � <br /> 2) mow-- M6 6 <br /> 4) <br /> 5) <br /> 6) <br /> 7) <br /> I g) <br /> 9) <br /> i �� _ / ,� ` •s SAMPLE IP ECRrT1/CONDITION&TURNAROUND TIME17 <br /> fc <br /> RECEIVED COLD A INTACT I I F.S NO ( } <br /> RE IAQVI\HED RY m'vkc DATE/TIFIE_� REC'LI\ED BS a�..n..c ATE!TIME- PRESER\ATI\ES USED �5 ES } NO } <br /> CINTODI SEALS INTACT I I us } NO } NA <br /> AIR RURBLF4 IN%OA \ r 1 F\ ( } I,u� UI,L x <br /> RLLINOUISHED BS ATL/TiHE DATE./T1\SE <br /> TURA AROUII D T!Ali: ('IlECA O,\F <br /> RLI INQLS 31ED Bl ar.an�c, 1,-TL/TIME_ l_CF1111-1)HI I-4HORATORI DATE I TIME U HOUR 48 110UR } DAI } 90 VAI <br /> NOTE- LABORATORY SAMPLE ARCHIN'I\G WILL BE 30 DAPS fRONI THE DATE.S4\IPLE WAS COLLECTED,UNLESS OTHER ARRAI\GE4'IENTS ARE NIADL <br /> PI FAST RETURN DEL-TECH'S ICE CHEST AS'D BLUE ICE AS SOON AS POSSIBLE THANKYOU DEL-TECH FORA'/ C O C <br /> PITsh Fleld (om I I W14m R, iinl 1„ ( h,nI ,kith Rt,uh, <br />