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- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING # �1� 7 <br /> RECORDOF 1 DATE RECIEVED �_._— f <br /> LAB INVOICE TO _�.._------------._..-- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 ..... .. .�.... �--- ►------------------- ---------..—.._.—..—.— <br /> OFFICE-(209)847-8757 Q� <br /> FAX .(209)847-7744 PH# --------) �.E.y CONTACT .., .—._.__.._........................__...--....... <br /> CALIFORNIA CONTRACTORS LICENSE#657366 l CLASS"A"ENGINEERING <br /> JOB# INVOICE#•- O <br /> LAB ANALYSIS REQUESTED SITE SAMPLING MAP <br /> CLIENT CONSULTANTVVD-T141 LL. LT914 f - t/L {NDS 4 O <br /> SITE NAME PROJECT I �. CJD {1. • s _� <br /> ADDRESS CITY Tb ST ► t� at C at5 <br /> '8 <br /> SAMPLERSIGNATURE 6- t3 m E• `�' /� W <br /> s1�PF.o vu WAYBILL# <br /> ANALYSIS BY TURNAROUND T <br /> IME DAX F E" G� ao W W <br /> SAMPLE I.D 0 DA E RT.I�ME+� CONTAINERS TYPE MATRIX REMARKS I LAB ID <br /> 1) <br /> 2) _ Z d7�' % <br /> 3) - s 5 <br /> 5) .� T Z <br /> a �r4'+f►' K <br /> Ll D WD y S I <br /> '' "y o�L, <br /> 9) Gr <br /> 10) <br /> ryko <br /> 11) <br /> 12) <br /> 13) <br /> wn 14) <br /> b ��� <br /> 15) ` <br /> RajNg111sfwoi R Bt �' S PLE 1CONDI O <br /> (SONATURE) I�! �f�K:,.� <br /> � d'D RECEIVED COLD A INTACT!YES NO f <br /> r PA l7ThlE <br /> Rfa.>HQu1sl�Dat f/�'jl/ � / S Re[ErvEDBY � � � p1R8LgBL85[NVO.AS /YES( NO '`L! 5 g <br /> 3 or O—WRE) -fir! /-c��r �_4 <br /> CUSTODY SEALS INTACT !YES� NO{ NIA f ) <br /> RFL➢4QU1511FD91 Rea;1VFD11 AITWE <br /> PRESERVATIVES USED ! YES ove NO <br /> I (SKir" URE) x <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE (M T.B.E.,T.A M-E,E T B.E,D I P FA T,B.A) <br /> B B =BAILE*KS COLLECTED IN THE FIELD F B =FIEM BLANKS COLLECTED IN TI*D <br /> NK FIELD COPS WHITE&t ELLO11 TO LAB WITH SAMPLES ELLOW RETLRN TO CLIENT W fill RESULTS AEI-TEIe C FORM 98 <br />