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SAMPLE CHAIN CUSTODY RECORD <br /> OEL-TECHGEOTECHNICAL SUPPORT (PLE . E PRINT) Lab. Analysis by <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 LAB INVOICE To . �- <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECORD OF PH # <br /> CLIENT / CONSULTTA�NT,:, �� P O.# INVOICE# <br /> I � 'L _fi�1 <br /> RP ANALYSIS REQUESTED SITE SAMPLE MAP <br /> ,,,l,� Z near*�sum <br /> PROJECT/SITE NAME (ITEMIZED AND CHECKED BELOW) tk�+'�O (NORTH) <br /> JSTREET CITY ��TT A STATE C a <br /> ��V1HIP VIA <br /> SAMPLER sD sl rWAYBILL# <br /> ! k� <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE �qMp X <br /> EE <br /> (rDEA7rFICATION) MTBJDAI!}R HOUR/M!N DF {GRAB OR MAT,R[X <br /> Q6NTAINERs ooMrnsrrE) REAIAR S/ SPECIAL INSTR CTIONS BELOW <br /> 3) <br /> 4} --Z. <br /> s> - © U t L V 1 <br /> 6) tiAD <br /> 8} <br /> 9) <br /> la <br /> 1 l 1f fr I ss SUIPLE IATEGRITI I CONWION&TURNAROUND TIME ss <br /> RECEIVED COLD&INTACT I AES NO ' <br /> EL Q'ISHED B1 n w ATE f TIME 1, ECEI�Eb�Ytie�rw�Ttntp ATE f TIME PRESERVATI�ES USED Li ES NO { �y �/ <br /> J CLSTODI SEALS INTACT f�}—S ? NO NIA f/I <br /> J' <br /> � AIR BUBBLES INV OA S ! 1 ES � � NO LINEN <br /> RELINQUISHED Bi DATEI TIME RECEIVED Bl uiGmrum IDATEITIME. <br /> TURNAROLADTIME CHECA ONE <br /> ELINQt ISHED BS DATE TIME I RECEIVED BY LABORATORY ATE TIME. 24 HOUR � � 48 HOUR � � a DAlk � 19 DAN <br /> NOTE LABORATORY SAMPLE ARCHIVING WILL BE 30 DAYS FROM THE DATL SAMPLE WAS(.OI.I F(.TFD,t NLESS OTHFR ARRAINGEMFNTS ARI;MADN <br /> PLEASE RETURN DL L-TECH'S ICF CHF.S f AND BLUE ICI;AS SOON AS POSSIBLE THANK YOU DLI-1 FCH FORM C O C <br /> Pink - Field Copy / White & Yellow - To Laboratory with Samples / Yellow - Return to Client with Results <br />