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lam' t ["-' [—1 r " <br /> m- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY LAB.TRACKING #: --------- <br /> ----------------- <br /> RECORD OF _� DATE RECIEVED: -..__.':1 !-, '.r-_.... <br /> DEL-TECH�'C$� GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE To: #-�-et''=``---- ------- <br /> 10624 OLIVE AVENUE,OAI{IlALE,CA-95361 AIAz` # �° ' � L'A ni'S3al _ <br /> OFFICE-(209)847-8757 <br /> FAX .(209)847-7744 PH.# ' .CONTACT: <br /> CALIFORNIA CONTRACTORS LICENSE#657366/CLASS"A"ENGINEERING ) ;�-C <br /> OB# ---------------------INVOICE#-----------—---.-----------P.O.# -------4. ...,.. �------------- <br /> "'- E i, LAB.ANALYSIS REQMTF.ID SITE SAMPLING ASAP <br /> CLIENT: T �` �, �r� CONSULTANT. <br /> . 3Ir a <br /> si <br /> srrENAnsE: fi �_ PROJECT: <br /> SITE <br /> IA h CITY � ST.: , 2 yI p <br /> a " <br /> SAMPLEIt�SIGNATURE: O d n €- �' a. ' <br /> SHIPPED VIA: WAYBILL#: <br /> a t s � <br /> ANALYSIS BY: ��� `' � � TURNARouN1lTG4fE: ;`VDA� DAY �" �' � W w � w W � Al PA- <br /> SAMPLE LD.A DATE TWE CONTAINERS TYPE MATRIX �, REMARKS J LAB.I.D. <br /> g Y ui•i.i ;� a l;i l... <br /> 2} <br /> 9 � <br /> tv <br /> jr` - <br /> =4 <br /> S 0.) <br /> 11,} <br /> l2.) <br /> L14)13*1 r# <br /> 4 / DATE/ <br /> RELINQUISHIM sr; TPAE <br /> ' EYED B' Az�/ SAMPLE INTEGRITY CONDITION <br /> ' r (s1oNeTUR�y !r /Ana./1° f RECEIVED COLD&INTACT/ YES. )r NO ( ) <br /> A ! E <br /> REL(Nwrsx D BY: R£CEfY®Bl, DA'1E/'IThSH - <br /> 3 .,.: AFR BUBBLES IN V. <br /> O.A.'S / Y13S r NO {} LINES H- <br /> F-,1i'+�C' l5-NATURE) 1�'0'y :-i:-�:w,-!:4-�j.f-.. .—I,' .+.. ,f,:l: �E CUSTODY SEALS INTACT ! YES.K ) NO f ) N/A f 1 <br /> v 'J ATE I � „m <br /> REUNQDISHM BY: R6C21VED BY: DATE l TikIS PRESERVATIVES USED I YES <br /> isfg 7 (SIGNATURE) I O V S 3m>a <br /> NOTE: PLEA.SF ARCHIVE THE SAMPLES SUBMITTED FOR THP.PULL HOLDING TIME ALLOWED"UNLESS OTHER ARRANGEMENTS ARE MADE. 'k (M.T.S.E..T.A-M.E..E.T-B"E.,D,LP.E.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLECIED IN THE FIELD. F.B.=FIELD 13LANKS COLLE.CTE)IN THE FIELD. <br /> PINK-FIELD(YIP%' WITITE&'CF.I,T.t)W-T"FAA WIT H.CAMPT.FR `-T:I 7 nW-RGTIMN TA rT IFNT WTWn Dccnr TC _ nrr —1.r <br />