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C'77 <br /> ANALYTICAL QUEST f SAMPLE CHAIN OE CUSTODY RAC <br /> LA$.TKING #: <br /> 4cs REQUEST ---- -- ---- -----------RECORD OF DATE RECTEVED: �i <br /> LAB.rnvotcE To: ------ -.: ._ .. �_ �—�'�-------.._---------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES , <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ----ck <br /> J� __L_ _...��_-.ti�, sr ------ <br /> OFFICE-(209)847-8757 <br /> FAX -(209)847-7744 PH.# ------- --) � - �+-1.CONTACT: w- <br /> -- --- ------------------- <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGUiEERING <br /> 08# .................---...INVOICE#---------------------------P.O.# -.. .- -)---�55_�----------- <br /> LAB_ANALYSIS REQUESTED SITE SAMPLING MAP <br /> CLIENT: CONSULTANT: s �� <br /> d <br /> SITE NAME: an 124PROJECT: !up,, <br /> C7 GI ac <br /> ADDRESS; .jjCITY -31 <br /> SAMPLER SIGNATURE: 1 947 1 <br /> C � vi <br /> SHIPPED VIA. WAYBILL = = Ww � cc an <br /> � <br /> ANALYSIS BY: TURNAROUND TIME: DAYS �" F W W W <br /> SAMPLE L.D.# RATE TIME CONTAINERS TYPE MATRIX E �� ",:` �• - '`{,, REMARKS/LAB.I.D. <br /> 1.) — <br /> 2.) O <br /> S') <br /> 4.} 1 <br /> saI L75-7 <br /> fi.} VX&M fr <br /> i <br /> 8.) / <br /> 9.} <br /> ID.) <br /> 11.) <br /> 1 z.) <br /> 13.) <br /> 1a) <br /> 1 S.) <br /> IT <br /> ull nvoutsi a Y: ' 17 ! RECEIVED BY: SOD SAMPLE INTEGRITY/CONDITION <br /> (SMATURE) / ��' RECEIVED COLD&INTACT I YES , NO ( 7 <br /> TIME "-'ITNE <br /> i FLELINWlSHED BY: 1� ���[1 RECENED BYz j"+�� /[Q ?�C�' AIR BABBLES 1N V.O.A.'S !YES ( 1 NO i LINE(S)f!- <br /> �x5 1d l iSIOHAT� la,� "�`t /h"� P CUSTODY SEALS INTACT ! YES,y"f> NO f i NIA i Y <br /> DATV DATE ITME <br /> RELNgUISHFDBY: RECErVEDB4` PRESERVATIVBSUSED 1 YES f i NO f .� <br /> ! (SIGNATURE <br /> _ NOTE: PLEASE ARCHUV E TfiF SAMPLES SUBMFFMD FOR THE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. � (iVI.T.B.E._T.A.M_E.,E.T.B_E.,D.I.P.E..T.B.A.) <br /> B13 =BAILER BLANKS COLLEC-MD IN THE FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> vauor�.a vvi i-tv-rn r A n W F-M RAMPF R.0 VF.T f.nW-R PTUR N Tn CT.1FNT WfT}I RFS1I1.T.9 DFL-TECH C.O.C.FORM 99 <br />