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o • <br /> ANALYTICAL REQUEST/SAM& CHAIN OF CUSTODY-- LAB.TRACKf� #: ___. 3 <br /> RECORD _ OF _ DATE RECIEVED ----- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES ------- <br /> LAB.INVOICE TO - - - �n� f.•1. &Y-A <br /> ----- <br /> ------- <br /> ------------ <br /> QQ �j`�f� l �-� <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 -12-- __1,----- '��>'."�A y-—�f _. .-----{.L, d�------ ------_---_- <br /> OFFICE-(209)847-8757 -- 2L.CONTACT: --- -----�-- �-- j.'- �� <br /> FAX -(209)847-7744 PH.# .d <br /> CALEFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING OB# --------------- -INVOICE#---------------_-_----__---_r.0-# --------------------------------•------- <br /> " LAB.ANALYSIS REQUESTED SITE SAMPLING MAP <br /> n+olr�, <br /> CLIENT: e'ePREC <br /> : f1 t' <br /> SITE NAME: _-. <br /> ADDRESS s i ST.: O <br /> SAMPLER SIGNATURE.SH[PPI?D VIA: <br /> C7 R oao allo o�o <br /> ANALYSIS BY: I TURNAROUND TIME: DAYS F [� � W W � W W <br /> SAAlPIE I.D.! 4TE TlhlE CONTAINERS TI'PE MATRIX REMARKS I LAB.LD. <br /> i <br /> 1.) - e 3 T)�Z <br /> 2.1 vZ A' <br /> 3.) <br /> -) z 8 <br /> 6.) <br /> 7.} G V <br /> a.) <br /> e , <br /> 9.} <br /> IL} <br /> 12.) <br /> 13.) <br /> 14.} <br /> 15.} <br /> LA <br /> RELINOUISfBD 85': i' •/- �^(� R <br /> ECEIVEDBY: y� Z SAMPLEIN7'1:GR17Y/CQNDITION <br /> i J" CEIVEb COLD&INTACT I YES ( NO f <br /> DATE ITUOIE <br /> RELINQUISIEDBY: AIR BUBBLES IN V.O.A.'S I YES NO( LIN S)CUSTODY SEALS INTACT I YES (X) NO( } NIA t } <br /> DATE I TIME <br /> RE!B4Qt3lSHID BY: RECEIVED BY: PRESERVATIVES USED I YES �1 NO f <br /> 1 (SIONATURE) ZQQX�. <br /> NOTE: 14-EASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. * (M.T.B.E.,T.A.M.E.,E.T.B.E.,D.I.P.E.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PINI:-FIELD['OPS" WHITE&YELLOW.TO LAB.W ITII SAMPLES YELLOW".RETURN TO CLIENT WITH RESULTS DEIrTECH C.O.C.FORM 99 <br />