Laserfiche WebLink
SAMPLE CHAIN OF CUSS ODY RECORD <br /> DEL-TECH GEOTECHNICAL SUPPORT' (FLLASL PRINT) Lab. Analysis by : <br /> 10624 OLIVE AVE OAKDALE, CALIFORNIA 95361 LAB INVOICE 10 C.j <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 RECORD OF13 PH # { ) <br /> CLIENT 1 CONSULTANT: 0�0,u-`Egj G r.0 #/ INVOICE# <br /> ANALYSIS REQUESTED SITE SAMPLE MAI' <br /> [PROJECT t SITE NAME ,, (ITEMIZED AND CHECKED BELOW) R°rT°s`""' <br /> ndw—a, Wl\TII�M �1RTk1 <br /> t tr,C�d �R�-USM �1aRy I j < <br /> vv <br /> STREET CITY SATE CA <br /> T m b4.144uC3 (Gal) HIP VIA <br /> SAMPLER (PRINTED SIGNATURE) WAYBILL# <br /> 3AA <br /> SAMPLE LOCATION DATE TIME NUhtBER TI'PE SAhfPLE <br /> OF (GRA$OR /-� <br /> (IDENTIFICATION 1 MTHIDAVI R HOUR I MIN CONTAINERS COMPOsrrE} hlATRIX F--( REMARKS/* SPECIAL INSTRUCTIONS BELOW <br /> z) t/0- 10.5 ' OS3a <br /> 10 4 <br /> 6) <br /> /0- to.s 101z <br /> 7} SAW-Z V`ra• 4°.�D4 <br /> s) t b O. 5 oc)og N( - <br /> g) Icor k A- k IN- <br /> 110) IDES �� oy <br /> SAMPLE ENTEGRITI 1 CONDITIOA&TURhAROUAD T141E +• <br /> RECEI]ED C OLD&INTACT I I ES NO <br /> RE 1,11EA sx N+n x i ATE I TJ ME REC EI]EU 61 DATE f TIME PRESERI ATI]ES USED I l I's � } h0 L <br /> 111,TOD] SEALS INTACT I 1 ES NO WA <br /> AIR BUBBLES IN V U A S ! 1 ES NO LINE R <br /> �IQLIIIIIEDTL DATEI TIME ECEIVED 61 1511 N+TLR6 E/TIME <br /> T1 RAAROLAD TIME rill CAO]F <br /> � <br /> R NQE ISIiED B ..w�NAnRe ATF�7'fRF� <br /> PIPIC411111,I)BYLABORATOR) OTrTINNAR.' TL11F 1TF f TEMF 2� 110EJR i } J8 Ellll'R FfA] } 10 IIA} { <br /> Nl)TP LABOT IIR1'SANIPI,L ARCHIVINI. )VII 1,BP 30llAY's IRONI THP DATP %A111'1 F RAS COI 1 Lt1PD,l\I LSS 01HPR ARRAINGENI NIS ARE SIADH <br /> PI HAST' RF 1)PI FECH'S ICI;CHP. f AND BI Uh ICP AS S(H)N AS POSSIBLH THAN L 1), 11jFORM C()C <br /> ��� IIS � � � � � � �� � � 1• � L � A <br />