Laserfiche WebLink
11tL,r.1VI"U 111AK J I IaJ4 <br /> SAMPLE CHAIN OF CU <br /> ODY RECORD <br /> � Lab. Analysis b ��L -- <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLLASE PRINT) Y y ' - <br /> ]0624 OLIVE AVE OAKDALE, CALIFORNIA 95361 _ ! 13 f LAB. INVOICE TO L <br /> OFFICE (209) 847.8757 ! ! P <br /> FAX (209) 847-7744 RECORD �_OF H.# <br /> P.O.# INVOICE # <br /> CLIENT / CONSULTANT: <br /> ANALYSIS REQUESTED SITE SAMPLE MAP <br /> mar TO srwW <br /> �` AND CSHCRED BE7111Y 1 ' T(Nownu <br /> PROJECT!SITE NAME �}J�Lr. 1�"fL 11 (/ A <br /> N y <br /> uj <br /> wZ <br /> Y <br /> _j CID <br /> SITE, <br /> CITY � I V� STATE �f'F g w 1 o <br /> STREET $ COP LaIn w lL � <br /> 1� �� I�N� HIP VIA �[,L ^- � °= N W a U sa/ <br /> SAMPL itINTPD sIGNATU1lE) AY81LL �gj w o �; <br /> uj <br /> NUMBER TYPE SAMPLE = y a a x o c CD u <br /> SAMPLE LOCATION DATE TIME nF GRAS oR ¢ a r a cv N RI;AlARI(S I* SPECIAL INSTRUCTIONS 8LLO W <br /> (IMNT1FICATION 1 MTHJDA171 R NOIlR/MIN [}UNTA►NEiS pOMPpslTh) AlATRIX pp m �p Gp <br /> Z b — 1 <br /> �.) �• 2. Z�l� Z CL <br /> ,)� 1 $ <br /> 30p Z <br /> 9) iuj <br /> Io) Gtr •- v -3 V6 Zt- <br /> �� SAMPLE INTEGRAL l[)DNDITION&TURNAROUND TIAIE •• <br /> -{/7 RECEIVED CDI�J&INTACT ! YES J NO <br /> ' ATE!TIME. PAESERVATIV FS USED E NO { <br /> NIE8Y $ai ATE!TIME 3 B2 aiGwiTva9! ( <br /> CUSTODY SEAS INTACT 1 YES 1 NO NA <br /> AIR BUBBLES IN V OA 4 ! YES � ' NO � LINE A <br /> ATI I TIME E}l ED Bl /siGmvuMc� ATH! ME <br /> fNQUISHED Bl Er n TURN AROUND TME CIIECh ONE r <br /> RE[1NQ}IS][Fp g} Kw raT�x6 )ATLI IIAlF I.CHIIrf;U RI "BORATORI' "Tr TIMwa•[L'NITIN! )ATF I TIMP <br /> lR }IUl1R f9 PAI <br /> � � ]iAl � � <br /> NOTE LABORA SAMPLE ARCHIVING WILL BE 30 DAPS FROM THE DATE SAMPLE 11' )LLECTEII,UNLESS OTHER ARRAINGEMENTS ARE MAD DFL T1'ORM C O C <br /> PLEASE RETiI TECH'S [GE CHEST AND BLUE ICI!.AS SOON AS POSSIBI E THANK <br />