Laserfiche WebLink
DEL-TECH SAMPLE CHAIN OF CUSTODY RECORD Client N <br /> Address STY <br /> (Geotechnical Support Services (please print) Phone No. 1D5 <br /> Pro]. MgrXontact V Q)L F��.S <br /> -• 10624 Olive Avenue <br /> Oakdale Calif. 95361 urs r// Pink-Field Copy <br /> White and Yellow-To laboratory with Samples <br /> (209)847-8757 Record_of_ Yellow-Return to Client <br /> PR0.IECT/SITE NAME:� Ip � �, s \ ANALYSIS REQUESTED <br /> 13+x` <br /> PROJECTICONTRACTIPO NO.: �b <br /> NAME OF SA PLER: /. REMARKSISPECIAL INSTRUCTIONS i <br /> LAS USE OlkyJ I S M LE a m NUMBER <br /> OF <br /> LAB I.D. DATE TIME O CON- 1XXX[JJJJ %}; <br /> O TAINERS r <br /> TK- 1 0 3 ak3ak a34 ! -(K Is t1W- Fr� ' <br /> �s T IE WEd;t TA4 No, 21734 - <br /> TK" S 1li; <br /> �x 4 5 = w kT A No_ 217 3 <br /> bT�k41� y3 Nt 21-73.6. <br /> I . <br /> No. 21737 <br /> rl�c e <br /> flELINQUISHED BY SIGN DATE/TIME RECEIVED BY SIGN DATE/TIME RECEIVED FOR LABORATORY <br /> S p <br /> BY(SIGN): DATEITIME <br /> RECEIVED: <br /> OLD AND INTACT OTHER PRESERVATIVE DYES ONO <br /> ❑OTHER: <br /> TURN AROUND TIME: <br /> SHIPPED VIA: r1FEO X r111Ps VhTHFR' zmp"', ""P N/l 024-Hr 02 Day 05 Day )710 Day <br />