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, <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB TRACKING 0 <br /> RECORD OF _ DATE RECIEVED -- - -- -- -...- <br /> -- -1_�� -----�= �1�_�•__`�� ».:�_----- --. <br /> ---- �_--- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE TO <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 - <br /> OFFI[E.(209)$47-8757 ( 6$�3g 7_ h1� :�i� <br /> FAX .(209)847-7744 PI3 --}�- <br /> CONTACT _......_. - - . <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> JOBN ---------- --I OI Ii_.............---------PON - _._........_..._. <br /> LAB ANALYSIS REQUESTED SITE SAMPLING MAP <br /> a, AL. CONSULTANT t% <br /> SITE NAME � PROTECT I{� 1'1rt 8'�1 Q <br /> �i <br /> gL CITY � ST '�+ I'�kI Z <br /> ADDRESS <br /> SAMPLER SIGNATURE bn 14 U <br /> SFIIPPED VIAZL`C. WAYBILL# <br /> ANALYSIS By AROUND TR13E DAY W $ W Wpn <br /> I SAMPIELD 0 DOTE TIME CONTAINERS TYPE MATRIX i ''' '''� i'r' r,{ REMARKS/IAB I_D <br /> �u li 1,,� , II l�„1 ,,i,I� II �, '� <br /> ,) _ D L <br /> 2) - S p L 4sa$S <br /> 3) r <br /> 4) L <br /> SI mow- �-5 C a <br /> 6) r �h dK C <br /> T) .. �! a D <br /> bum <br /> 8) ra n L a <br /> 9a <br /> 10) <br /> 11) <br /> 12.) <br /> 13) <br /> 10.) <br /> 15) <br /> �y RECEA F)Bi IMTE IG SAMPLE INT GRI 1 CONDITION <br /> RFI.WpDlgamliY frM <br /> all( [[ RECEIVED COLDS,INTACT 1 YES( NOTURn f <br /> RELZNQUISHM BY 1 <br /> A ATURR) "-,I lr� AECEW'^HY !!X17' <br /> !/' AIR HUHHLES IN V O A S !YES NO L1 r 5 A <br /> r (S-laTum r�� ? CUSTODY SEALS INTACT 1 YES kn NO( 1 NIA ! ) <br /> DATEITIME DATE/TAf6 <br /> ilk]41f�1i15S�81 RE F.1VID8) PRESERVATIVES VSED I YESkof Noe <br /> r (SKMTURE) l V jLXL <br /> NOTL PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE (MTBE,T.A M.E,E T B E,D I P L TBA) <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD f B =FEEM BLANKS COLLECT U IN THF FIELD <br /> PINK FIELD COPT %HITS R I ELLOIti TO IAB K IT11 SAMPLES 1 FLLOSS RFTL RN TO(1 1E',T H LTH RF_SL LTS DF I TFCII 4 n( F[IR 4198 <br />