Laserfiche WebLink
0 <br /> SAMPLE CHAIN CUSTODY RECORD <br /> 4S� <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab Analysis by �-I✓ <br /> 10624 OLIVE AVE OAKDALE, CALIFORNIA 95361 LAB INVOICE TO Ve—— � { <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECORD OF PH # r7 I'll 5-7 T� <br /> CLIENT / CONSULTANT: �'�- r; �, P O # INV610E# <br /> ANALYSIS REQUESTED SITE SAMPLE MAI' <br /> EPROJECTE NAME �-T� Cc" \ (ITEM17ED AND CBECAED BELOW) IHOT To sc.0 (NORTHIt <br /> ZO� t"''' CITYU� STATES'+'' oM co <br /> CC z `� + `+p�q' T C�" <br /> Lr) �iu C-;) CD °C cc <br /> g o <br /> 64 HIP VCA m = o z m UD <br /> WAYBILL# <br /> SAMPLER (P SIGNATURE) I" co o m a <br /> FS <br /> CD 0 c w= <br /> I <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE SAMPLE `� =w x o a o <br /> OF (GRAB OR = _ F— <br /> (IDENTIFICATION) MIHJDAf1}7P HOUR/MIN � � aol�POs►TE MATRIX m opo o m REMARKS/* SPECIAL INSTRUCTIONS BELOW <br /> 2) W&O <br /> 4►I s ""„ \p i�O Z <br /> 5) - - lt15 <br /> 6)JV� - 3 6�1 z <br /> 8) PAM <br /> EO) i <br /> G p / ••SAE1PI6INTECRIJI/CONDITION&TURN4ROUND TlAfE " <br /> RECEIVED COLD&INTACT ! I FS NO <br /> NQ iSHEU 81 n ATV k! T !TIMES-' i�,E, Bl esu��rusu ATE!TIM£. PRFSFR\ATI\ES[3SED ! 1 ES � ti0 <br /> CINTODl SEALS INTACT I YES { NO iVA_p<� <br /> AIR HLIHHLLS IN\O A S ! YES } NO UNF 0 <br /> ELINOUISHED Rl O;W Y TVkt, )ATE 1 TIME REL EI\Ell$1 1511 uTvku DATE!TIME <br /> rll� <br /> URA AROUND TIME CHECA UVF <br /> Il Y � y� f/,J <br /> �I I�iQI ISIUJ)H+ EI ��TI kE �nTF r�r+If .CFIt'>;U!t} l..1KOK Ilk1 M1TF Ti L��k,�L+�l�ll�li nTF 1 �1{fa IIUI R dN IIOUR } DAl—� 10 DAI <br /> NOTE LABORATORY SANIPLE ARCHIVING WILL BE 30 DAYS FROM THE DATE SAMPLE WAS COLLECTED,UNLESS OTHER ARRAINGENIE\TS NRE MAD- <br /> PLEASE RETURN DEL-TECH'S ICE CHEST A\D BLUE ICE AS SOON AS POSSIBLE THANK YOU DEL f ECH FORM C O C <br /> P.,11. I I, I I ( -m I `vVh,T( A V� 11nn Ire 1 11-n1 11(m »illi S ' +tllo%+ R(Imrl to Ci m urlh R Itlt� <br />