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--- <br /> -• KLEINFLDR ST TAT: Standard CHAIN OF CUSTODY-- LAB.TRACKING #: ---------------•---------- <br /> 224001 IIlIIII lllllllllllliil lllII�II III!l1111111lIIIIII IIIIIIII --------------------------- <br /> DATE RELIEVED: - <br /> _�_�— ' .new � ..---------------------------------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE TO: -- ------------------ - - - - -------- <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ''��� ------�----`'-=-�------- <br /> OMCE- 209 847-8757 <br /> FAX -(109)847-7744 PH.# (-I---�-)- ------_....CONTACT: -..��G� � ------------ ...............-. <br /> CALIFORNIA CONTRACTORS LICENSE#657366!CLASS"A"ENGINEERING <br /> OB# ------------------- #------------------_.---P.O.# ---------------......................--- <br /> 1117111111 <br /> . <br /> E f I "'` !"'±i; "``; `; i t I I LAB.ANALYSIS RE uESTED SITE SAMPLING MAP <br /> i l ilIIII I, t � . . k� Illlfi II II II I IES�ISE �i .��! .�.I II III.I.I III ill i f �I � lilt iliii��l'�Eh,l<<� ��k� k� pili i I H�''i I �����.�i IILI'�I�I Q <br /> CLIENT: CONSULTANT: LLI �t.� m <br /> SITE NAME: PPROJECT: ' 1 &A% <br /> ADDRESS: j. �T CITY: ST.: O (4 4 <br /> H � <br /> SAMPLER SIGNATURE: V6r r <br /> SHIPPED VIA: WAYBILL#: x d u F+ <br /> ANALYSISBY: TURNAROUND TINE: DAY(S) W m m <br /> Ill,li SAMPLELD.4 DATE TIME CONTAINERS TYPE MAT= it III I III I I I II i Illli I {ai III k',IE If IE, „ it I REMARKS/LAB.LD. <br /> I) S ? <br /> z) 3 <br /> 3.) -0-0 .-v s <br /> 4.> s 3 o C <br /> 5.) I IO S-o r <br /> LIS 44 <br /> ,) <br /> B) � � Gf <br /> 10.) <br /> 11.7 <br /> 12)1 =mby <br /> 13.) y <br /> 14.) L bj)_% <br /> 15) <br /> A / DATE/1 .y <br /> Ijz.woUISHEDRY: LL b RECMVEDDY: SAMPLE INTEGRITY lCONDITION <br /> fMNAllrM (SONATURE) ° RECEIVED COLD$INTACT 1 YES NO ( ) <br /> I UA DATE f TIME <br /> RELPIQUISHM BY: RECEN:D BY: AIR BUBBLES IN V.O.A.'S 1 YES NO Ll S R- <br /> g r (Sr-NkTME) ! CUSTODY SEALS INTACT 1 YES NO ( ) NIA f <br /> DA7VID& D TE.ITRAF <br /> RQ.INQU15}4D BY: Rin'®BS': / PRESERVATIVT?S USED ! YES _ NO <br /> S GNA ! (SIDNATIlRb) vl�-(� �Z V <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. (M.T.B.E.,TAME.,E.T.B.E.,D.I.P.E.,T.B-A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS C.OLLECTID IN TETE FIELD. <br /> PINK-FIELD COPi' WHITE&VELLOW•TO LAB. ITH SAMPLES YELLOW-RETURN TO CLIENTWITH RESULTS DEL'TECH C.O.C.FORM 99 <br />