Laserfiche WebLink
.. ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- �LAB TRACKING # -.._.............. <br /> RECORD <br /> _L OF € DATE RECIEVED ----- ----------_-- <br /> LAB INVOICE TO .---�; .'�w ��...�'�''Y� � "'* c � �` <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES ----- --�----------- - ��•-___w__� _______________--_...- <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 _ - __l <br /> OFFICE-(209)847-8757 4 <br /> FAX -(209)847-7744 PIi# z :=: <br /> (---- —�-}�- CONTACT -_�;--;�= <br /> C <br /> A <br /> L <br /> IF <br /> ORNIA CONTRACTORS LICENSE#657366 CLASS"A"ENGNEERING=17 r . OB# ------------ <br /> - -I O <br /> # tr[omn --I <br /> LAB ANALYSIS REQUESTED SITE SAMPLING MA <br /> P <br /> a : CONSULTANT <br /> ---`- <br /> ------ <br /> SITE NAME , PROJECT L9 t <br /> ADDRESS CITY tmL <br /> ST <br /> SAMPLER SIGNATURE I x )- <br /> SHIPPED vTA �a WAYBILL# ,.� -' 6 <br /> ANALYSIS BY �� TURNAROUND TIME `° 3 DAY(S) <br /> h MMPLEID A DATE TIME CONTAINERi TYPE MATRIX I!',I REMARKS I L4B I <br /> dy aA > s <br /> >J' <br /> LREEMIQUISHM'B'l <br /> r'F <br /> + S t R IVFSf BY DATE!TOAHs <br /> f rf, ' SAMPLE INTEGRITY 1 CONDITION <br /> h <br /> � I 9AT7E <br /> RECEIVED COLD&INTACT 1 YES a F*NO ( ) <br /> X A1 <br /> DAA rTmE <br /> RUINQUfSHED 81 f ^_ _ r` f `; RECEIVED g! E AlR BUBBLES iN V O A S 1 YES { NO f s LINE(S # <br /> s A ~�' - I r' r (SKMATU' ) CUSTODY SEALS INTACT I YES (+') - NO( i N/AI 1 <br /> { i A 1 DATE 1 TWE `" I <br /> Rr�1HQu[S1�D B} I1ECF[VED Bl PRESERVATIVES USED ! YES NO <br /> t <br /> N 1 (SKINA7URE) <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED UN[�ESS OTHER ARRANGEMENTS ARE MADE (M T.BX,TLA M.E E T_B.E,D ILP E TBA) <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br />