Laserfiche WebLink
-- ANALYTICAL REQUEST/SAMA CHAIN OF CUSTODY- LAB TRACKING 4 <br /> RECORD 1 OF DATE RECIEVED � ----- <br /> LAB INVOICE TO ---- l�.. _�...... <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES �r A� <br /> I0624OLIVE AVENUE,OAKDALE,CA 95361 � �.._. <br /> OFFICE-(209)847-8757 j O� <br /> FAX -(209)847-7744 PH# (`G-----f--)-5-0 _._- ._CONTACT - ...--....................._........_.-----_ <br /> CALIFORNIA CONTRACTORS LICENSE#657366!CLASS"A"ENGINEERING <br /> OB# # ------------.__......_...---------- <br /> I€ €I p , I LII' li I„' <br /> ,I€I�.ill�E� LI lig,'j l,��,I�IG�fflf l� � I I�IIhI,I III ��i LA$ANAtYSIs teeQuFsiED SITE SAMPLING MAP <br /> CLwNr CONSULTANTIWO CMD <br /> Q PoRml) <br /> SITE NAME PROJECT t i <br /> ADDRESS <br /> fjE <br /> SAMPLER SIGNATURE a E- 0 1 <br /> SIRPM YIA �. WAYBRL# II <br /> d 47- <br /> 0.1. y� <br /> ANALYSIS BY TURNAROUND TIME DAY ' paj W will., <br /> 1111 SAMPLE LD I DATE TIME CONTAINERS TYPE MATRIX `�ii 1i1!111 <br /> i'Ii' ftl Ilil,iii I lili� if �l 13 � �n'li i li�l REMARKS I LAB I D <br /> 2) <br /> 3) DIEM <br /> 4) <br /> s) t S15 <br /> 6) - 5 Z <br /> 7) _ p <br /> b <br /> e) V L L <br /> IB) <br /> 11) <br /> 12) <br /> 13) <br /> 14.) <br /> IS) <br /> REWdQU15}IID Bt }Y RECEWM IM ! A1E 17➢4f& <br /> ` �I �; � !- /�"� SAMPLEINTEGRITY/CONDITION <br /> 1 (mNA7l1RE) \ 7 ��j RECEIVED COLD&INTACT 1 Y8S fAe NO ( ) <br /> REL [5F®BBR7 _ 7 REC£IVM <br /> 44 <br /> AI 67 I ATn E <br /> a q f ( ABURBLES IN V O A S I YES NO LIN S N <br /> h`I`'�`�� J .1 ,�I I (S1GNA7UR� I �C� C-� C' ) CUSTODY SEALS INTACT ! YES ( NO! 1 NIA ( ) <br /> RELWDAZE r 94yIE QUISM 61 RECEIVED B5 PRESERVATIVES USED J YES f NO <br /> ! (51(INA'111RE1JYPE OF Ht0WgA=5), kIrl, <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUDWITED FOR THE PULL HOLDING TIME ALLOWED UNLESS O'T'HER ARRANGEMENTS ARE MADE * (MTBE,T.A MX,E T B F,D I P E,T B.A) <br /> B B =BAII ER BI ANKS COLIXCTED IN THE FIELD T B =FIELD BLANKS COLLECTED IN THE HELD <br /> PINK FIFLD(Opti WHITER 1 ELLO%$ TO IAB KITH SAMPLES SEI 1 OR RETURN TO CLIENT"IT11 RESULTS DFI TFCH C 0 C FORM 98 <br />