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4r <br /> SAMPLE CHAIN O USTODY RECORD <br /> DEL-TECH GEOTECHNICAL. SUPPORT (PLEASE PRDM Lab. Analysis by : li:_ 2- <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 LAB. INVOICE TO :<�Ejjc <br /> OFFICE(209)847-8757 <br /> FAX (209)847-7744 RECORD_I_OF �� PH.# <br /> CLIENT 1 CONSULTANT: 1►] 1C , P.O.#/INVOICE# <br /> CJ�$Tll� ANALYSIS REQUESTED SITE SAMPLE MAP <br /> im"0801 <br /> PROJECT/SITE NAME: 1 N <br /> (flEdlI7JD AND CSECI>QD 8E7At►) (NORM <br /> STREET- 131 ► 1E L DaW VTOZY- ro� STATE.�-. � � >� !�� � � � , <br /> v cn o¢ <br /> m r UV <br /> l.�� � HIP VIA. o = Z m MW3 <br /> AYBILL I D 2 w < <br /> S[[ TA1T1Ais) w <br /> CO p � w O�{g�Ll'■57 , <br /> W <br /> = a 2 <br /> SAMPLE LOCATION DATE TIME 1YUMBER (GR4B ON � CL r o a J ` • <br /> (m�sA�rFrartoN) arr8�trrPe •oulel�ullc aoxrAiNSBs im urns g) MATRIX r m Go 0000 00 G REMARKS/'�SPECIAL INSTRUCTIONS BELOW <br /> ►) �a 1 <br /> %>63 z <br /> 3) <br /> 4) % <br /> 5) ►vw t <br /> i <br /> 17) Yom) -1 ,�r <br /> 41 <br /> 9) fhw <br /> swrLE rrrrscxm i aaxamoH E TURNAROUND 77MB <br /> RECEIVED com a INTACT 1 YES NO <br /> BY ATE I TIME. RECEIVED BY DATE/TIME. PRESERVAMES USED %` YES NO 11 <br /> CUSTODY SEALS INTACT I—YES ( ) } NIA <br /> AIR BUBBLES IN V(!A.'S I YES NO JA LINE# <br /> INQUISHED BY 01atunanLATE I TIME EIVED BY aicw i ATE I TIMB <br /> TURN AROUND TIME CBECE ONE <br /> INQl.7SHID BY cirwnnu <br /> ATEITIMI-. RECEIVEDB}'LABORATORY .mttnmxmotaswt- DATEITIME M HOUR = , 48 HOUR } S DAN } 10 DAN <br /> NOTE LABORATORY SAMPLE ARCHIVING WILL BE 3D DAYS FROM THE DATE SAA'IPLE WAS COLLECTED,UNLESS OTHER ARRAINGEMEN-I S ARE MADE <br /> PLEASE RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE THANK YOU DEL-TECH FORM C O C <br /> Pink - Field Copy / White & Yellow - To Laboratory with Samples 1 Yellow - Retum to Client with Results <br />