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--'ANALYTICAL REQUEST/SAAIP CHAIN OF CUSTODY-- LAB.TRACKING #: L _ 0 <br /> RECORD OF DATE RECIEVED: <br /> LAB.INVOICE TO: .. � ,.Z--- Af,_ �2'[` .....-...................... <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA,95361 <br /> ONCE-(209)847-8757 1 _ i$ �_� �. -� -- �- <br /> FAX -(20W)847-7744 PH.# CONTACT: ..._.----- ----- <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING OB# -------------------INVOICE#------------- O.# ------ ---..-__......-------.--.--- <br /> I ",`€I j. 11 , " SII' '' 'i I I I LAB.ANALYSIS REQUESTED SITE SAMPLING MAP <br /> I .i ..'. ... L ,.•..• <br /> CLIENT: r 1>r(�(� CONSULTANT: <br /> CHA <br /> SITENAMI;: ZgjlLlW ZazseCTPROJE : <br /> ADDRE.SSIN CTTY: ST: <br /> SAMPLER slcNATURE: ..1 MW 3 <br /> o n <br /> t e ,7 evo <br /> m to <br /> SHEPPPEDVW 1,L WAYBILL.#: x Wl C e $ d � 'Mr <br /> ANALYSIS BY: RNAROUND TIME: D DAY � E� W W W mw <br /> SAMPLE I.D.# DATE TIME CONTAINERS TYPE MATRIX „ ii` ,' .' <br /> REMARKS/LAB.I.D. <br /> I.) <br /> 2.) IN 3 <br />� 3.} <br /> L <br /> 4.) Ob �. <br /> s., U V <br /> 7.) <br /> 8.) <br /> 9.) <br /> co <br /> 11.) <br /> 13.) <br /> 14) <br /> 15.) j Al <br /> DATE)TIME <br /> j p � Argy. , �_��� SAMPLE INTEGRIT}'/CONDITION <br /> RELINQUISHED BY: • ti#1 � <br /> Q Ip (SIGNATURE) RECEIVED COLD&INTACT I YES{/) NO f ) <br /> A 1) ITME <br /> RiT mQ[nslffD By AIR BUBBLES IN V.O.A.'S ! YES NO� L1NE(S M- <br /> RECEIv>vBY. _ La <br /> fSIGNAT[)RE) CUSTODY SEALS INTACT I YES I NO f } NIA ( [ <br /> W A .! DATEfTIME <br /> Rf.I.R�'QuaI DBY; RRCEWWRY: PRESERVATIVES USED I YES (el NO ( <br /> (SIGNATUitEI i O V <br /> i <br /> NOTE: PLEASE ARCHIVE THE SA.4IPLES Sk'Rkl[TTED FOR THE PLTIA.HOLDING TIMF ALLO%ED,UNLESS OTHER ARRANGEMENTS ARE NiADI:. (\1.T.LI.E..T.A.M.F..,I:•T•B.F.,D.I.Y.F..,T.B.A.) <br /> B.B.=BAILF.K BLANKS COLi,NCLED IN TM:1lELi). F.B.=FIELD BLANKS IN TIIF?FIELD. <br /> PINK•FIFLD[YIPY WHITE&YELLOW-TO LAB.WITH SAMPLE-S 1'FLLOR'-RETURN TO CLIENT WITH RFSVLTS DEI:TECH C.O.C.FORNI 96 <br />