Laserfiche WebLink
SAMPLE CHAIN O CUSTODY RECORD <br /> 4� DEL-TECH GEOTECHNICAL SUPPORT (PI.LASL PRINT) Lab Analysis by F&L <br /> 10624 OLIVE AVE OAKDALE, CALIFORNIA 95361 LAB INVOICE TO kjA_L" W k1t_ <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECORD OF PH It <br /> CLIENT / CONSULTANT: V L. Who j W,,4 jL=-g + gS P O # / INVOICE # <br /> -j1M 1. +Vj VA j_.LSITE SAMPLE MAP <br /> ANALYSIS REQUESTED <br /> PROJECT!SITE NAME h-4r"TM4 x -b- !fT£MIz£D AND MECr£D BELOW1 <br /> (NORTH <br /> ern To �1 <br /> STREET �� �t CITY � STATE <br /> 1 TIP V IA <br /> H <br /> SAMPLE RVfMSIGNATURE) AYBILL# <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE /yp <br /> (IDENTIFICATION) MI'9JDA)IYR fIbUR/M!N OF (CRAB OR MATRIX <br /> avxTAIN£Rs dDMPOSITIC) REMARKSI* SPECIAL INSTRUCTIONS BELOW <br /> 2.) vy" _ 1 <br /> 3) V%V+.) fiep 1 ?) 1 <br /> 4) yvAA)" 2.— 11711Z BLL ?Nbft <br /> s) vw10• $B i %91* Pr1 8'rz: UMV1906 <br /> 6> tVVZ- 3 Z is <br /> 8> <br /> 9) 1� <br /> =10) <br /> ,�^ � /- *•SAMPIF I NT£GRMI/CONDITION&TURNAROVAD TME •• <br /> \ RECEIVED COLD&INTACT / IIiS NO { <br /> FLI Q SHED SA rs• ATE)TIME DA;510 RECEIVED S} ,•rrn,.n•n ATE/TINIEE�� PRESERVATII M LISRD E_S NO <br /> i I'STODI cFAI S INTACTI )EES i NO {fl �rr VA AIR Sl'&SI ES IN V O 1 S r I FS NO y/) I INE N <br /> ELINQUIfiIIEDBr s'�rATL.t L ATE1TIME r, ECUVEDS\ ATE/TINE <br /> TL RA AROL\A TIAIF 4,111.L AO\I <br /> RH I%QI ISIIE[)Sl )ATF 1 TI%1F 14-h11/1'1)RY 1 ABORA TOR} .,n n•..x <.i n iE SFE/IMF ra )uoL'R f tri HIII'K ) 1)\1 { ) 10 1)A] Iy <br /> \011h I AHOR\I'O)R1 tiANIN h ARCl1[\'1\( N\I11 Hh M) DANS hRO1\I 1111 1)1%1p I 1\ \ti C01 I I CIPI) [ \I h\\ OEHhK \Elle\]\( h\Ih\I'% \Ilh \IAI)p <br /> P1 hxq Rh IURN Uhf IhC)1 ti ]Ch C1{HSI A\D III UF ]Ch As "(H)\ \` 1101"AHl h f H\\h \o1 DI I I1 ( 11 1 0R\1 C O)O <br />