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I � — TAMREMAIN O USTODY REC(M <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab. Analysis by <br /> 10624 OLIVE AYE. OAKDALE, CALIFORNIA 95361 LAB INVOICE TO :_? _ Wit EEM • <br /> OFFICE(209)847-8757 `` hoc b Wvc <br /> FAX (209)847-7744 REICORD-OF I PH.# DZ <br /> CLIENT I CONSULTANT: P.O.#/INVOICE# <br /> ANALYSIS REQUESTED SITE SAMPLE MAP <br /> FPROJECT/SITE NAME• rY�+6x1 T�s�t (ITEMIZED AND CHECKED BELOW) "Of°"""' <br /> (No <br /> cn v, <br /> S f7 �� <br /> L � * g <br /> STREET: s ITX• � SPATE: �f`1 �o a� — i arc cc �r <br /> Wo a ¢ M <br /> W 0 <br /> e �� A v T W G W � V] <br /> N HIP VIA- �+� m a <br /> SAMPLER- sIGNATU M <br /> WAYBILL �dJ i <= o `� a <br /> i Ir: O J m J 2 r � <br /> � < <br /> NUMBER TYPE ca a �, x o D o v <br /> SAMPLE LOCATION DATE TIME � � <br /> OF (GRA$OR Z 2 4 r cu ti <br /> (HIISNTIFICATION) AnizimYIYIC HOUR I MIN �NrAINERs � ) MATRIX EL H m co m m REMARKS/* SPECIAL INSTRUCTIONS BELOW <br /> 1) —' t 3 �LE� � <br /> 3 <br /> 4) yywor-- S t4ZV 3 <br /> s) YYVVa dl� P553 <br /> — <br /> ck) 1�— � 59 <br /> 9) <br /> 10) <br /> SAMPLE INTEGRITI/CONDITION A TURNAROUND TIME <br /> IP, D RECEIVE?COLD&INTACT I YES NO ( } <br /> REFJ NQUTIE)BY air ATE/TIM JA ECEVED Bl rsiowtuRu ATE/TIME. PRESERVATIVES USED LYES NO ' <br /> CUSTODY SEALS INTACT / Y/ ES NO ( NIA <br /> AIR BURBLES INV OA'S I YES y NOLINE f <br /> E)Bl FwwTWE. ATEITIME ECEI►ED ] csicwTcreT� ATEI ME <br /> TURN AROUND TIME CHECA ONF <br /> [tRNQUL11S-1,1f1fE1'1V an�.nn�kei ATE!TIh1F LE11�/3I)I�} LABORATORY �f Tt TtVN UM TIME ATF I TIME / / HOUR 48 HOUR � � S DAl � � 10 DAN <br /> NOTE LABORATORY SAMPLE ARCHIVING WILL BE 30 DAYS FROM THE PATE SAMPLE WAS COLLECTED,UNLESS OTHER ARRAINGEMEN'TS ARE MADE- <br /> PLEASE RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE~ THANK YOU DEI,-TECH FORM C O C <br /> Pink - Field Copy / White & Yellow - To Laboratory with Samples / Yellow - Return to Client with Results <br />