Laserfiche WebLink
i`t 1 <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING # �� <br /> RECORD OF DATE RECIEVED --- . __—_.__ <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE TO ---C� ---- 1=-.Z'- r ------------------------------- <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 ----------------------------------------------------------------------------------------------------------------------------- <br /> OFFICE-(209)847-8757 <br /> FAX -(209)$47-7744 PH 4 (-----------)-------------------CONTACT <br /> CALIFORNIA CONTRACTORS LICENSE 0 6S7366/CLASS"A"ENGINEERING <br /> OB#i .._.._._.-----------INVOICE#.........................-P O # ------------------------ <br /> ! {I 1!II+III IIII�,I3,I III'II,I,€ I li ', I'r�II€III!'€III' I lilllll�lll,I,Iliiillillli�lilljlll llllll'I, fl II'�l,iil Ji,ilii ili,iiiiil i €ifi`f{hi ail it lilli€Illl�lilljl i,ll'I I'I," LAB ANALYSISREQUFSIED <br /> dlllll I SITE SAMPLING MAP <br /> CLIENT ) \ CONSULTANT �5` (MRM <br /> AT <br /> SITE NAME T' PROJECT ► m t N4. tv ft r`T� 1 2 � "Y a <br /> ADDRESS crrY �[' T� sT h o 1 � <br /> SAMPLER SIGNATURE ,y y <br /> N �� � o � E" c o � 1' � s <br /> SHIPPED VIA WAYBILL 0 <br /> ANALYSIS BY TURNAROUND TEWE DAY(S) <br /> ,I SAMPLE DATE TIME CONTAINERS TYPE MA TRI% I ll III P ulm u <br /> � Ilial; ,Il , I�'I€I u,II I' .II. €1131113 s..>>' '„III Illilll illi�ll REMARKS/IAB ID <br /> 2) -- r, �� :5b i <br /> 3) ' & 1 <br /> 5 6 7.� <br /> 6 1 z <br /> c <br /> 10) - �.3� ua <br /> am <br /> 11) - � , <br />! 12) <br /> l3) <br /> 14) <br /> RELINQUISRFD 01 ; kt�' �P4D8N �, / DATE{� SAMPLE INTEGRITY/CONDITION <br /> 444 , t915>oNA ,. <br /> (MNATUPR — RECEIVED COLD&INTACT I YES ( 1 NO ( r <br /> DATE DATE r TIME <br /> RELPIQUIS11FZf Bt / i I i r� RECEIVED111 �T , r , ` ”' , •" AIR BURBLES 1N V O A S r YES f NO f LINES M <br /> fC (SIGNATURE) .� _1,__, �'.` �1��_ i a 'l: { <br /> >'� Y CUSTOAY SEALS INTACT 1 YES ( , NO( I NIA ( I <br /> DATE I I DATE ITIME <br /> RELINQUISHED a) RF.C£IVFD EI PRESERVATIVES USED r tES 1 NO ( <br /> r (s[GNAIVREJ r1XPEOP=L&VAjIVVSI <br /> NOTE PLEASE ARCHIVE THE SAMPLES SURMITPED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE * (MTBE,T A M F F.T B E,D I P I' TBA) <br /> $$ =BAILER BI ANKS COL[ECIED IN TIQ'FIELD F B =I7ELD BLANKS COLLFC I-D IN TM FWLD <br /> PINK FIFLD(OPI 'A HIT£A t LLLO41 TO 11B%ITH S4MPLES )FLI Ott RFTURN TU C LIENT%$ITII RFSIII TS IIF I TF(H( O( FOR 4T 98 <br />