Laserfiche WebLink
E <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB TRACKING it -------- -------.- <br /> RECORD 1 OF � DATE RECIEVED ----------.-------------- <br /> LAB INVOICETO --- `" _.` ..._. _.....' ,,-t..�........_._------ <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 15 <br /> 10624 OLIVE AVEN[1E,OAKDALE,CA 9536171+1 10�' fp <br /> OFFICE-(209)847-8757 ---------FAX - 209 847-7744 <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> 'LOB# --------------------INVOICE#--........._.____._...... FO # ._ <br /> Ip'rrrr II r uq ' 'I r 'I nI rlli I k rlr"11 ",°I I Iwupr rl Pqr I',,Irl r ' Irr' 13 I' IPf'rllrklE!' If ° ' e li Ir rhrl`N,III I`R'I!I Ir rt r r i _ ------- <br /> r <br /> _ -- <br /> fi I I it h[ I u Ilu r r 11 Ilil I r!I'm1a i r r r w'' I ir14h rr«r f r rll r r r I! II dkrhlrl fr'ttll 114I1rr I' !ur]I , r pi ,gll+n'l Illi'illi i r w i LAB ANALYSIS REQUESTED SITE SAMPLING MAP <br /> CLIENTS i '� CONSULTANT � w a `"°�' „ <br /> SITE NAME PROJECT • .8 <br /> ADDRESS 0x6 3 O CITY ST j <br /> SAMPLER SIGNATURE ` 7F- <br /> q <br /> SHIPPED VIA aima=2WAYBILL# <br /> CpC, il+ d Q d d R <br /> ANALYSIS By TURNAROUND TIME DAY �r �, W W 2 <br /> r SAMPLEED DATE TIME CONTAINERS TYPE MATRC 'l rliIrll I <br /> REMARKS I LAB ID <br /> `) Iii M M i <br /> 4) <br /> 5) �` <br /> 7) ! <br /> lo) <br /> vo <br /> � -- <br /> 11) <br /> Ix) <br /> 13) <br /> 10.) <br /> RELINQUISHEDB1 �i !` TaNH Pxi V BY :} �� O� lJIIY[E <br /> NA <br /> �� SIMILE INTEGRITY/CONDITION <br /> (slaruTVR�j lG� (���U RECEIVED COLD&INTACT /YES } NO ( } <br /> air r <br /> RELUQU1SHM BY f I f r !!.%�4 � RF�UVE.p a5 , c6 AIR BUBBLES IN V O A S 1 YES NO LINE 5 Oe- N <br /> s ( ' e £M •771 (smmTUR� d f�Q/��f C+ T.�` G CG ter J i� CUSTODY SEALS INTACT /IFS ) NO ( 1 NIA ( } <br /> ATEITAUE ( ( DATEITIME <br /> REtihUQtStsltffitai RECEIVEDRI PRESERVATIVES USED I IFS aNO{ <br /> ! (SIGNATURE) / V �Lr+ <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MAD& � (M T B.E T A M_E,E TZ.E,D ILP E.,T B.A) <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br /> PINK FIELD COPA WHITE R I ELLOW TO LAB W ITH SkMPLFS 1 ELLOW RETURN TO CLIENT W ITH RESULTS DEt TECH C O C FORM 9E <br /> 1 <br />