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63 <br /> -- ANALYTICAL REQUEST/SAMP RAIN OF CUSTODY-- LAB.TRACKING #: - ----- -----•----E I LA <br /> RECORD OF DATEEVED: --------•-- --...--. <br /> LAB.INVOICE T%--F <br /> nn.tli!- ---•-Lom----L ec` - - <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES E - C <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ----1 93----9 ..cs e_c��i_ _LO�.---._T 1{.....!-� . <br /> ( ) R I r V :Iie,�b��rc <br /> OFFICE. 2a9 847-8757 <br /> FAX -(209)847-7744 P CONTACT: <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> 1013# --------------------INVOICE -----------. ------ --P.O # -----------------•-------------------- <br /> LAB.ANALYSIS REQUESTED SITE SAMPLING MAP <br /> CLIENT:Fry)%\' ll Emlinecr CONSULTANT: - �►1 l v� <br /> I <br /> SITE NAME: )PROJECT: <br /> ADDRESS: 1 , CITY:—Mi 11 0 <br /> SAMPLER SIGNATURE: O oe % <br /> WAS YBILL#: A w °0 °° <br /> s1IIPPEDvu: a a a mw-3 <br /> ANALYSIS BY: TURNAROUND TIME: DAY(S) <br /> SAMPLE I.D.R DATE TIME CONTAINERS TYPE MATRIX ;;.I. REMARKS/LAB.LD. <br /> I.) C, Q <br /> 2) <br /> 3.) <br /> 4) <br /> 5) <br /> 7.) <br /> B.) G 01 _ <br /> 9.) F <br /> I0.) <br /> E l.) <br /> 12.) <br /> I3.) <br /> IC) <br /> DATE I <br /> I5.) � +� <br /> RELJNQULSHEDBY: ` to- Rr rvmee: .�/ �1 �!�7 � SAMPLE INTW817T/CONDITION <br /> (SK7NA'R1RE) /• �J' �•� RECEIVED COLD&INTACT I YES (") NO { ) <br /> y <br /> RELINQUISMED IM �/ /d T �f/ >ar�[�D BY: AIR BUBBLES INv.o.A'S /YES( ho ( Llt E{5)# <br /> 171-�a {SKiNA1S RE} `�;`�F_�1\-�l- I• ,C� n �1, I GU CUSTODY SEALS IIV-FACT / YES.f/ NO! NIA ! ) <br /> A I t l Y DATE17AME <br /> RELL"NQUISHM BY: RFJMIVED BY; PRESERVATIVES USED I YES NO f <br /> / I$IGNATUREI t V <br /> NOTE: PLEASE ARCHIVE"IF.SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED.UNLESS OTHER ARRANGEMENTS ARE MADE. (M.T.B.F..T•A.M.E.,E.T.B.E.,D.IX.E.,T.B•A.) <br /> B.B.=BAILER BLANKS COLI ECI'ED IN THE FIELD. F.B.=FIELD BLANKS COLI.f;CTFJ)IN THE FIELD. <br /> PINK•FIELD c'OPY WHITE A I'ELL()1S'-TOLAB.M'ITII SAMPLES YEI,I.(1l1'.RFTURNTOCLIENTM'ITII RFSI'LTS DEI:TECH C.O.C.FORM 98 <br />