Laserfiche WebLink
'S i - � F•�, may- � - <br /> - — -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY.. LAB.TRACKING #: <br /> RECORD OF DATE RELIEVED: ---. ' .. ._ <br /> LAB.INVOICE TO: -- �-- --� _------.--:- -- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES �° ` '��" - --- - -__ <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 .___�"__...I..:_.___--- �� --�_- ----- +_,t±i � <br /> OFFICE-(209)847-8757FAX .(209)847-7744 PH.# CONTACT: .... ------CALIFORNIA CONTRACTORS CONTRACTORS LICENSE#657366!CLASS"A"ENGINEERING ' <br /> '' .iji'!iEa�•I ii' !!c I�kl i li 1{,il f kh'.,!ifli ahf 3'iII'�•ih:II,I,i .I II,I] { r,,.;. -I I I E.il', f, .I- _I ,I illi I E Iii ' Ili E ill{: k" -------- -- <br /> SITE S <br /> �I'Ill ;'E 1 I �E�I i I; I Ii1 3 i�ilEl�l' Ili„ 'l III SII II LAB.ANALYSIS RE UFSIID _ <br /> AMPLING MAP <br /> CLIENT: CONSULTANT: <br /> STIENAME• OLIQ PRO,IF,C;I': <br /> ADDRESS: CITY: . , ST.:'fi <br /> SAMPLER SIGNATURE . _ Q yl o ad F o o <br /> a' I� -• � nH o0 <br /> SHIPPED VIA: '. WAYBILL# •� n a aQo 00 0�0 <br /> ANALYSIS BY: , A yD TURNAROUND TIME: r' f DAY(S) F W w S'o W W <br /> �j SAMPGEIAN DATE TIME CONTAINERS TYPE MATRIX kl'" {dl lj 'I�if�` REMAIIKSILAB.Jam, <br /> '. - 3 l <br /> XX <br /> , <br /> ', 1 1 1 <br /> 9., HE- <br /> .01 <br /> 1.) <br /> I4.) +" <br /> s <br /> RELINQUMIFD BY: DATE r 7u�IH <br /> s RECEIVED Hr: 1 R=, Se4M LL INTEGRITY/CONDITION <br /> a,. 3 SAiNATU '��.a-r .i '•,..-.�1-.1�Y--,•r�'.��r� <br /> J ) 1 r s ;P , RECEIVED COLD e&INTACT I YESDATEI <br /> NO <br /> RECEIVED HS'' • rF "DATE!'I{ME <br /> AIR BUBBLES 1N V,O.A.'S I YES ND. LIN S q- <br /> '- ';*y, f ,! CUSTODY SEALS INTACT' 1 YES NO { N/A f 1 <br /> t J f, V'FJ {SKiNANRE) y j '(, (" n.3 '......' �' ) i <br /> DATE I TiM6 <br /> RF1.AIQVISIIID HS', RC�F.[S+ED HS: PRE5ERVATN85 USED / YlsSNO <br /> iAzw&mgElr (sAGP:A-FU ! v <br /> MOTE:PLEASE ARCHIVE TUE SAMPLES SUBMITLED PORTIM FULL HOLDING TIME ALLOWED,LENILSS OTHER ARRANGEMENTS ARE MADE. (M.T.B.E.,T.A.M.E...E.T.H.E.,D.I.P.E.,T.H.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THF,FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PINK.a.rrw h vot1v Ulf—R.—1 1 naa•_mn...o --.'F.l ew n,aor cc v r.r..+.0 r,cm..,....•.,,.r.�..•.•...•,•..,..-,- .�... <br />