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-- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB TRACKING # ------------------------- <br /> RECORD OF DATE RECIEVED ---- -____---___—_-- <br /> ! - LAB INVOICE To - -� 1-k�=--�,4 - --DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361 .t»_ -1_U -, �-_. �1� <br /> OFFICE-(209)847-8757 <br /> FAX .(209)847-7744 PH# {= ------)`�--`1-��` f NTACT <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS 'A"ENGINEERING - P O # -- <br /> OB# ---------------INVOICE#— ..--------- - ------- <br /> 1 ,, ,,,1 Illr,I , 1„ hli IIh h lu n 1 , I I I I III II;11+ I, ,,,,,,I LAB ANALYSIS REQUESTM SITE SAMPLING MAP <br /> � ,n, 'b; , I j'ril1�1 ii�,u,,,I II I���� r �1 Illi.I. ml, r �r,i �i ,r , � I rel, if rire f[ I <br /> CLIENT ;-I 1')hr , CONSULTANT ( — w g <br /> SITE NAME PROJECT St I � 1 ;n, .,t <br /> ;3 <br /> ADIfRFSS !i! CITY C, f( ST ' O_ lm wr <br /> I <br /> SAEOLR SIGNATURE '� <br /> SHff?ED VIA r r n WAYBILL# a y� m <br /> ANALYSIS BY P r t [ 'TURNAROUND TIME DAY(s) W 19 � [ <br /> II' ! SAMPIB LD.! DATE TAlR CONTAINERS TYPE I►rArxrx I;11 '1111 iil l�l! I ' !III ,1[lIN1 „i� I!j11'I 1!i1i111 h,l ill REMARKS I LAB ID <br /> 1) = � )� 3 , �, i f- <br /> z) <br /> 3) � <br /> 4) _ �( <br /> 7) r 1- ,� <br /> 1I, <br /> 1Z, <br /> _ 13) <br /> 14.) <br /> 15) <br /> DA'M} TDa <br /> 1u�rvm RI s _ 1 SAMPLE INTEGRITY 1 CONDITION <br /> Q (SKMTUP.E) : ' `f F RECEIVED COLD&INTACT I YES ( NO ( ) <br /> T A 4 DA7EIT2fE <br /> RTISIJFD BY � »g4 ALR BURBLES IN V O.A 5 1 YP,S ( NO LlNpm.(7 <br /> 1 (siauTunh] r CUSTODY SEALS INTACT I YES Vf NO ( ) NIA ( 1 <br /> DA7�I11� <br /> RF3Nqumm115 RSCEIVEDBY PRESERVATNESUSED 1 YES NO ! <br /> I <br /> ITYPEOF=mv S <br /> NOTE.PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE {MTBE TA A4 E,E T B E.D I P E TBA) <br /> B-B =BAM.ER BLANKS COLL.ECIED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br /> PINK FIELD COPS WHITE&I ELLO" TO I.AB WITH SAMPL ES I ELLOW RETURN TO CLIENTIA ITH RESULTS DEL-TECH C O C FORM 99 <br /> t <br />