Laserfiche WebLink
1 <br /> s <br /> -_ AANALYTICAL REQUEST'I SAMiCHAIN OF CUSTODY-- LAB TRACKING # --------------------------- <br /> 4C5RECORD OF .�,� (��� ;1`'�`� � � f� '� DATE RELIEVED ---------------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE TO - .7 '"- ; -- <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 Alb. ...... <br /> -- --- -- -' ------- <br /> OFFICE-(209)947-8757 A <br /> FAX -(209)847-7744 PH# (- ��-- - -...CONTACT ....1 -------------------------------------------------------- <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A" P O #ENGINEERING ,,9 . .�.__.,__ <br /> OB# ---------------_...-...I OCE ----------------............ -------_.... <br /> I f+ <br /> r rerr rp inw ' n rlEPRT)„ <br /> SITE SAMPLING MAP it f rEj ISE <br /> j MORM <br /> CLIENT CONSULTANT ki �R! <br /> SITE NAME PROJECT y & ! <br /> ADDRESS aCITY ST <br /> SAMPLER SIGNATUREy� <br /> SHIPPED VIA WAY$I LL# <br /> ANALYSIS BY r5 TURNAROUND TIME DAY(S) <br /> lPil' <br /> SAMPLE ID rf DATE TIME CONTAINERS TYPE MATRLC � �" , ��f Ir grin "`'r� ��r13 'J,If}IREMARKSIL" ID #IS <br /> rr � Ilki i„�,'r rrr rlf' r r IW rr r <br /> z) � I <br /> 3) isict <br /> 4) <br /> s) <br /> 6) ... <br /> 7) - . , <br /> 8) <br /> 9) <br /> 10) ^+ <br /> it) <br /> Iz> t ”' <br /> 13) <br /> 14) <br /> 1s) <br /> ATE 11ME ) ) DATE ITIME <br /> RaINvvlsHepBY r REcElvFaaY SAMPLE lNTEGRITY1CONDI77ON <br /> 'i (SIGNA RECEIVED COLD&INTACT I YES Z4. <br /> y'f DATEITIME " 1 _ DATI:ITIME <br /> RELINQUISHEDBY .. -.�-+r r �„ �- _ RECEIVEDBY �f d A� !f 4,} 1 i ` AIR BUBBLES 1N V O.A'S I YES NO LI S q <br /> if ! !G4�t�.� %� r f f f r ���` CUSTODY SEALS INTACT 1 YES NO ) N/A ] <br /> Y/ DATElTlh1E DATE/TItr1E <br /> RE.INQUISIIEDBI RECENEDBI PRF?SERVATIVESUSED I IES f NO <br /> 7 SIGNATURE) ESERVArWrgSi <br /> NOTE PLEASE ARCHIVE THE SAMPLES SLIBMUTED FOR THE PULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE <br /> B B =BAII FR BLANKS COLLECTED IN THE I IELD F B =FIELD BLANKS COLLECTED IN THE MELD <br />