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1 <br /> -- ANALYTICAL REQUEST/SAMP* CHAIN OF CUSTODY -- I All TRACKING 1i __ � .._ �RI;coRn ol; I1nTr.Rrcll:vt;D ----- =-- --- --- ----- T <br /> I� INvolcr To - - ' - _ _1�� <br /> ---------- <br /> DEL-TECH -J GEOTECHNICAL SUPPORT SERVICES c�131 U k�'96fy�xy1 � m VE�—b <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 ------------- --- - -- ---- ----�----Q---h----------1_______ <br /> OFF <br /> FAX -( -(209)-77 757 if` A� 7 3 5 —L� f Z f�--------- -- <br /> CALIFORNIA <br /> -1209)847-7744 PH# (- ----4--)---- --------CONTACT <br /> CALIFORNIA OONTRACTORS LICENSE#657366/CLASS A' ENGINEERING <br /> OB# -------------------INVOICE#-- — P O # ---------------------------------------- <br /> I; I al I i III'�hl�Il iJ, I�idryl I� �I' � �I d i i h I IG LAB ANALS SIS REQUESTED SITE SAMPLING MAP <br /> CLIENT CONSULTANT * <br /> SITE NAME P PROJECT �]1 I � .a. p <br /> -�* �C <br /> ADDRESS 5 LCL CITY 5 ` tU�TO ST ' � 4 � x O Xk <br /> 46 <br /> SAMPLER SIGNATURE 'T <br /> SHWED VIA WAYBILL# '—� A 020 � E• J )+I b <br /> ANALYSIS BY TURNAROUND TIME 6T, DAYS : w cc <br /> SAMPLE ID# DATE TIME CONTAINERS TYPE MATRIX 'I I ;I REMARKS I LAB ID <br /> I (S� 6 <br /> z) D4 Z I <br /> 3, D 6 <br /> 4) VVNJIA� - o g <br /> 5) •• <br /> 6) <br /> 7) N8 <br /> 8) S <br /> 9) a <br /> 11) — <br /> l i) xlr1J�- Z <br /> 13) — Y <br /> 14) <br /> 15) — <br /> � r DATEf3A{fi <br /> IZUINQUISIED BI r RB[FJVFL Bt 1 r r:pp SAMPLE INTEGRITY/CONDITION <br /> (sl[mA11IRE} 'QD RECEIVED COLD&INTACT I YES(-1) NODA TWE <br /> ( 1 <br /> REL NO)ISran BI / RECEIVED Bt % 1 AIR BUDDIES IN V O A S I YP.S NO <br /> fD (slcruTune) CUSTODY SEALS INTACT I YES ) NO{ NIA ( ] <br /> A f DATE I TIME <br /> R[LFNQll1511FD Bt RECE1VF131)t PRESERVATIVES USED 1 YES XNO { <br /> 1 {SIGS+IA1tIRE) r y <br /> NOTF PI CASF ARCHIVE THF SAMPLES SUBMnTFD FOR THF FZA 11101 DING TIMP ALLOWED UNITSS OTHFR ARRANGEMENTS ARE MADE * (MTB}; T A M F F T B E,DIP}: TBA) <br /> BB =BA11 I.R BI ANKS COI 1 I'CTLI)IN TIIF NZI-[I) I B =1 ILI 1)BLANKS COI I I(-7I1)IN I IIEI1LI D <br /> PINK FIFLD(OPI M FHTF&\LF 1_0ri1 TO I AB 111TH SAMPI F-S 1 F 1 I OVA RFTURN TO(I IFWT H ITII kFSUI TS DF I TF(9i C O( FORK1 98 <br />