Laserfiche WebLink
I <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB.TRACKING #: -----....................... <br /> 1-.,2-, v / <br /> RECORD OF DATE RELIEVED: --..-----------...---------- <br /> LAB.INVOICE - - ��.L....-: 1 . ..... . . ....... <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES 1 ' <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 <br /> QggZ�- ---- �� _�uc.Kidi . .... ......... 'A......... <br /> OFFICE-(209)8474757 <br /> FAX -(209)847-7744 PH.# <br /> r�- -� -CONTACT: .. 1.V.... �. .. .. t ...-.............. <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> OB# -- ----------------I O !5 <br /> CE#....._...._...._...---._._P.O.# -----_..._....._.........- <br /> I I II I I E ,I, -.hl LAB.ANALYSIS REQUESTED <br /> SITE SAMPLING MAP <br /> R+oanq <br /> CLIENT: L R CONSULTANT: (' <br /> SITE NAME PROJECT: c 1 p,; <br /> ADDRESS: • CITY: ST.: d 0 <br /> SAMPLER SIGNATURE: ` p o °' n V. <br /> SHIPPED VIA: WAYBILL V A <br /> ANALYSIS BY: '1 TURNAROUND TIME: DAY(S) <br /> SAMPLE LD.N DATE TIME CONTAINERS TYPE MATRIX REMARKS <br /> i Ilil I I Ilii. 1 II E <br /> 1'1 <br /> I <br /> 2.) <br /> 3.) m qoq <br /> 4) <br /> 5.) <br /> 6.) Y <br /> 7.) <br /> 8.} fk 41 <br /> 4.) <br /> 10.) <br /> 13.) 1­7LJil <br /> 14.) <br /> 15.) <br /> RELNQUISIEDBY: kjA <br /> RBCEEDBY: w/ �•` MTMEI <br /> S P F N G /CO DI TION <br /> I (SIGMARRF1 RECEIVED COLD A INTACT I YES ) NORF.CENID BY: ABR BUBBLES IN V.O.A.'S !YES NO LI S(s.NA•[uRE7CUSTODYSEALSINTACT IYES ) NO( N!ARECEIVED BY: PRESERVATIVES USED I YES NO ( <br /> ELiSIGNATURDr (SIGNAIUREr O V <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL 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 THF.FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PINK-FIELD COPY W HITE R YELLOW.TO LAB.WITH SAMPLES YELLOW-RFTURN TO CLIENT WITH RESULTS DEI,TECII C.O.C.FORM 99 :' <br />