Laserfiche WebLink
�.Im m } 1m � � I� � IIIIIII� IIIIII� 4r <br /> 700 1 � �SAMPLE CHAIN USTODY RECORD <br /> DEI.-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab. Analysis by ' <br /> 10624 OLIVE AVE OAKDALE, CALIFORNIA 95361 LAB, INVOICE TO _ <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECOIL® __j__OF PH•# <br /> CLIENT / CONSULTANT: �� l �" P O #>< INVOICE# <br /> L ® SITE SAMPLE MAP <br /> ANALYSIS REQUESTED <br /> PROJECT'1SITE NAME � )� { (ITEMIZED AND CHECAED NELDW) 0--- <br /> PROJECT `(r fNORTEI <br /> [n [n (n <br /> r _ Lo <br /> U <br /> �� j a JO U 1 <br /> STREET l IT STATE �� ICD <br /> a <br /> �wT HIP VIA m owc r o z Lu � toJ N WUSAMPLERtwo <br /> ED SIGNATURE) AYBILL 8 � y a� oo c� � <br /> 92 O J J H ti <br /> d F- W c a- _ <br /> WA <br /> NUMBER TYPE Ca m�, x o a o v <br /> SAMPLE LOCATION DATE TIME OF (GRAB OR s = n-CL I— v � —j <br /> (IDENTIFICATION) AfTHJDA)/171 HO[1R/M!N CONTAINERS GOMPOSITs) �T�X a � � co co ccoo oNo � REMARKS SPECIAL INSTRUCTIONS BELOW <br /> I" <br /> 3) p M I l K 1 tZ I`a°L7 <br /> 4) <br /> 5) <br /> 6) <br /> 7) <br /> 8) <br /> 9) <br /> )0) <br /> S4AlPtL IMfEGRlI1 I CONDITION&TURNAROUND TlAlJ: •� <br /> RFl E.IYEU COLE d INTACT 1 YFti,koj NO <br /> 11 N ISHED BY DATE!TIME RECEIYEP 84 DATE I TIME PRFSERVATI\ES USED P.e\/1 ES J// NO <br /> CUSTOUZ SEALS INTACT I YES NO t �I NSA <br /> �`� AIR BUBBI P,IN F OA ! YES } Nll I INF N <br /> UISHED BI arrmTuv� 1ATE- T�ittE RECILI%E[ 1 iso n+z.R A E LEM14E <br /> J TURN AROUND TIME CIIECA ONF <br /> )A7 k!TIM14F yYl�/ =4 110OR 48 HOUR IA1 [IAl <br /> 1 -4QLISII7drECEIIhD IY LABORATORI' WTE TtkhAlQVN1TIME <br /> � nATE!l IM1Ik <br /> /// <br /> NOTE LABORATORY SAMPLE ARCHIVING WILL BE 30 DAYS FROM THE DATE SAMPLE WAS COLLECTED,UNLESS OTHER ARRAINGENIENTS ARE MADh <br /> PLEASE RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE THANK YOU DEL-CECH FORM C O C <br /> D 1 T I I ! r It'[ 1 N, I4 f i 1 r 'th Q ,nr I V,lim, P wrn to Til »ith R- �iflk <br />