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i <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING # ------- -------------- <br /> RECORD OF DATE RECIEVED ---- - ------------------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE TO �1 "�`"' - y 75 ` ! <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361N <br /> OFFICE-(289)847-8757FAX -(209)84?-T744 PH# (= J= �' CONTACT -- ------------------------------------- <br /> CALIFORNIA CONTRACTORS LICENSE#657366!CLASS"A ENGINEERING OB# INVOICE#-------------------- ----P O # <br /> iIt Iilli I liI,kllllI ll I I�€IItI lliit,ll II 6I r i IIIfIIlIl,ql€r II I Irl II 13`€Il'€(�l I II i li�iI'ltr!II3I U,3I i,IIl1I1I E1€11I Iq III!)I,�E r II I r I€l IlIrlll l l€1tf ill FI1![Ir I Ii II E kr rE ' rlr lr I Irll Ir Ii,lr Ikr I <br /> - .1 111- <br /> ------------ <br /> ' ll11LAIL ANALYSES SITE SAMPLING MAPE <br /> J cd <br /> CLIENT CONSULTANT a O <br /> SITE NAME ZtMk PROJECT <br /> ADDRESS 17.q S ST <br /> SAMPLER SIGNATURE vis p o .s <br /> SHIPPED VIA IC4 WAYBILL# ••--•••�"' C� � � F, �� �4� <br /> tt pQ,, ao <br /> [ANALYSIS BYL� TURNAROUND TIME _D DAY(S) F m <br /> I'lll SAMPLEID I nATE TZWE CONTALVERS TrPE MATRIX ,I Il 11111 1111,€r II I!III II11,1J1 liililll II'!P iiliiilll 1111°liE€ 11111ii REMARKS I LAB I D <br /> II <br /> 1� Q <br /> 2, �- Q <br /> 3) V <br /> 4) -� <br /> 2110 I <br /> r TaT -+ _ <br /> �F <br /> }DA !74rdE <br /> x®aro(irslFn lir RBCEraD Bl • � SAMPLE INTEGRITY/CONDITION <br /> (SUNMUiEE1 RECEIVED COLD&INTACT! YES NO ( 1 <br /> DATE I TRAE <br /> RS[FR>msY AIR BUBBLES INV0A S !YES NO('If LINE(S)!! <br /> 3 =„aw ^�T rr rt - 1 (StaNAIURE) I CU51 ODY SEALS INTACT 1 YES (-*< NO( NIA ( ) <br /> DAIEITU& <br /> RS�gr DATHITA(8 <br /> � Q1BY zr PRESERVATIVES USED 1 NO ( <br /> '`G�Y ! (SKNATURF) O V S _ <br /> 3 <br /> 4NOW_.K.EA5EARCHIVE THE SAMPLES SUBMITTER FORTHE FULL HOLDING TIM@ ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE � (M TA E,TA M E,E T.B E,D IT E,T BA) <br /> -,Bp=BAI!kR-BLANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br /> Hwy M r 'FINK=FIELD COF1 - WHITES YELLOWS TO LAB.WITH SAMPLES S ELLOW RETURN TO CLIENT WITH RESULTS DEL TEL-if C 0 C FORM 98 <br />