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L ��1 <br /> 4t- <br /> SAMPLE CHAIN OF .CUSTODY' RECORD <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT). Lab ,- Anal,Sis <br /> ' 10624 OLIVE AVE. OAKDALE,CALIFORNIA 953b1 <br /> LAB. INVOICE TO . x <br /> 5 10 WYVind <br /> � l '; <br /> OFFICE(209) 847-8757 <br /> FAX (209) 847-7744. RECORD OF PH.# <br /> =r <br /> CLIENT/CONSULTANT:•' Lis . � b'a~T .'L : E1� '�' )N <br /> P.O.#/INVOICE# <br /> _,... <br /> < M+p <br /> - - --- -- - -" ' - - NA -- A a � MA SITE RESTRA <br /> CEECIEDBEAW)PROJECT ISITE NAME: <br /> � <br /> -� (NORTH) <br /> A <br /> STREET:. CITY STATE <br /> r HIP VIA: s a r4 <br /> fir '! <br /> SA "tPRlnrrED sICNATOREI <br /> WAYBILL# <br /> • <br /> SAMPLE LOCATION': DATE. TIME NUMBER TYPE SAMPLE <br /> (tDENT�FlCArtoN)p- " AfMJDAI%YR. eovx/AflN MATRI% "" REMARKS/�`SPECIAL INSTRUCTIONS BELOW <br /> Llt)NTAlNERS COMPOS17fi) <br /> ri <br /> 000 <br /> s.} <br /> RIA k& <br /> 6-)'. • , <br /> 7..) <br /> Low) , <br /> lop <br /> Cl 1 a SAAlP1E lNTEGRR'1'1 CONDITION A TURNAROUND TIME •• <br /> L!J- RECEIVED COLD&INTACT ! }'ES � NO <br /> EL DISHED rviu: ATEITIMD ECEIV BY:s�rrusv�qDATE ITIME: PRESERVATIVESL�SED �YES NO { <br /> CUSTODY SEALS INTACT.! YES No { NLA <br /> '- _----�^•l AIR BUBBLES 1N V,O.A.'S I YES { } NO LINE/ <br /> ELINQVISHED BY:cr;ruiv��r ATEI TIME: RECEIVED BY:mcxuTuu: DATE TIME: . <br /> TVRN AROUND 11AIE: CHECK ONE - <br /> RELINQVISHED BY: ' ATE I TINE; RECFIVED BY LABORATORY:. DATE 1.TINIE: 23 HOUR ae-IIUt!R S-DAV <br /> SPTE: LABORATORY SAMPLE ARCHIVING WILL BE 30 DAYS FROM THE DATF.SAMPLE WAS Cl)I,LE;CTF.U,UNLESS OTHER ARRAINGFMENTS ARE MADE:. <br /> `i;EASF RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON,AS POSSIBI.E. THANK YOU DE:1.=1'F.CH F[IRY1 C.O.C. <br /> '' Pink - Field Copy / White & Yellow - To Laboratory with Samples / Yellow - Retum to Client with Results ' <br />