Laserfiche WebLink
.. - � �� 3•- ,, - � •~S � _ - �. � � �• .. ,-' 1 ..: -- .� - f, ry' -Y-_I•�F�-S X13, T �. <br /> ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTDDY LAS TRACKING, <br /> Nd 3 ,r <br /> RECORD OF -. . a _ _ .DATE RECIEVED.. "- <br /> r - LAB.INVOICE T Faft - • , T - <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES y(Ij LL1 <br /> 106y2+4 OLIV�EMAV�EyNOUF,I OAKDALE,CA.4536123- <br /> OFFICE-(W')OYl 01,1 A $ YY �. � �.'_. :S_ <br /> FAX -(204)947-7744 If. {� 1!��� ACT:_ <br /> CALIFORNIA CONTRACTORS LICENSE 11 GS7366!CLASS"A"ENGINEERING'-: 7 <br /> OB# ---INVOICE#=-- -– P.O.# --------- — <br /> :i <br /> ANALYSIS REQUESTED - MAP — <br /> ii,;(jl:rr! �((!{ ! [[(„i;IfEli,IIIIIIIIIIIIar! kir!I IIII III IIIIlIIII ifilliil!I�IIIIhIIli3ililljlifl it I.I'illl II'iirlll!i Illllllhlllllrllr,f;[ill. f.rl I Ili•,!I Ir!illiliEllliill:r:lll•I.I IIII!I)Irl:.l,,Il,uflllr: REQ SITE SAMPLING <br /> CLIENT: CONSULTANT: Ix7 nr F k: <br /> SITE NAMEId <br /> : PROJECT <br /> k- ST. x _ _ a . <br /> ADDRESS: CITY - y n <br /> SAMPLERSIGNATURE: <br /> cs <br /> $ o -615 <br /> o <br /> ' WAYBILL#! G7 p w $ Y <br /> r- SLED VIA: <br /> AI1AI YSIS BY: <br /> 'i_- TURNAROUND TIl4IE: '„ DAY Er W w m W W <br /> +111111 SAMPIBID./ :=DArE.� coNrvxtiJies rrP� - �rsrwx 1111111 Ifl#I i[ If!I,II "1111 Illlllii iflfli,l iiil.i ;ilillli ,I?II�II; =liil, REMARKS/LAB.I_D.> <br /> XK <br /> lrA <br /> -Ll <br /> 9.) ' <br /> 12-J ♦♦ i y^ - _ j _ y w 3 tii <br /> 13) <br /> 14.) <br /> RELWpIILS}IF•D BY: �. A 1 ne�vm HY: i^.M1, _ ,5�7-mlPi's . - SAMPLE INT6CRITY/COND1rION - <br /> IstclvAfuRey /y I RECEIVED COLD A INTACT 1 YES NO; <br /> DATE1TIMF <br /> RF1INQ1175}{ED HS': - .. RECENmHY: - - LAlJ6BLE51N V,O.A.'S 1 YES NO L S #-' .. <br /> _ 1 (SRINATURE) ODYSEAL5INTACT /YFS NO(- ` NIA:'f <br /> VAMITIML <br /> DA7E17T4[E HY: FRVATAMS USED ! YES NO <br /> (SMNA7URS) x ,�! O ., V, . ., <br /> NOTE: PLEAS ' ' LIVE THE SAMI'IES SUBMITTED FOR THE PLSLL HOLDING TIME ALLOVIED,UNLESS ffI[�R ARRA NTs ARE MADE 4` (M.T .E.,T A.M E E.T.B.E;D.1.P T.B.A.) <br /> B.B.=BAIL ANKS COLLECTED IN TILE FIELD. F.B.=FIEID BLANKS COLLECTED IN�L D. <br /> V <br /> C.O.C.FORM 9E <br /> FINK-FIELD COPT' WHITE&YELLOW-TO LAB_WITH SAMPLES YELLOW•RETURN TO CLIENT WITH RESULTS I1EI. <br />