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Client }# iL1N` st <br /> ry 1 �, b <br /> DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Address o3t� �.itA 1 <br /> Geotechnical Support Services (P Phone No. �� <br /> lease pint) r' <br /> Proj. MgrJContact <br /> 10624 Olive Avenue Pink-Field Copy <br /> Oakdale Calif. 95361 white and Yellow To Laboratory with Samples <br /> (209)847-8757 Record of Yellow-Return to Client <br /> ANALYSIS REQUESTED <br /> PROJECTIS��-IyTE� NAME: ��'�`� -�' � ! <br /> PROJECTICONTRACTIPO NO.: <br /> 1�/ <br /> L� t3 �'�.Tom- '�J ftEMARKSISPECIALINSTRUCTIONS <br /> AME OF SAMPLER: i <br /> NUMBER <br /> LAB USE ONLY SAMPLE ( a OF <br /> LD. DAT£ TIME O s CON- <br /> LAB I.D. V 0 TAINERS f <br /> 4 <br /> RELINQUISHED BY SIGN DAT,EffIME RECEIVED BY SIGN DATEITIME <br /> RECEIVED FOR LABORATORY <br /> ,i' fr '�� 3 '� BY(SIGN): DATEfTIME <br /> RECEIVED: <br /> COLD AND INTACT OTHER PRESERVATIVE YES DNO <br /> DOTHER: <br /> TURN AROUND TIME: <br /> ` SHIPPED' ❑FED X DUPS OTHER: <br /> T i SHIPPIN ER NO.: 024-Hr 02-Day 05-Day 0 Day <br />