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Client <br /> DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Address f;. <br /> Geotechnical Support Services (please print) Phone No, <br /> 10624 Olive Avenue Pro]. MgrXontact t �� <br /> Oakdale Calif. 95$61 Pink-Field Copy <br /> White d(209)847-8757 Recon_ I__of ellow-RetuYellow Client gyratory with Samples <br /> PROJECTISITE NAME: t � ANALYSIS REQUESTED <br /> PROJECTICONTRACTIPO NO.: <br /> M F SAMPLER: REMARKS/SPECIAL INSTRUCTIONS <br /> LAB SE ONLY MPLE a m NUMBER <br /> LAB I.D. I.O. GATE TIME CON- <br /> TAINERS <br /> IV' <br /> I <br /> RELINQUISHED BY SIGN DATEfTIME RECEIVED BY.SIGN DATE/TIME RECEIVED FOR LABORATORY <br /> r,f, ''�,� �- ;_- tit': i.'.' �i��'✓ BY(SIGN:-- -- - :.=..,_ DATEITIME <br /> I <br /> RECEIVED: <br /> )kCOLD AND INTACT OTHER PRESERVATIVE DYES t*O <br /> 00THER: <br /> TURN AROUND TIME: <br /> SHIPPED Vf FED X CUPS ©OTHER: i �_ -- SHIPPING R NO.: 024-Hr D2-Day 05-Day T7 in Day <br />