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1 <br /> -- ANALYTICAL REQUEST/SAMM CHAIN OF CUSTODY— LAS TRACKING # <br /> RECORD OF i ---------,-1-------------_- <br /> ` BATE RELIEVED <br /> LAB INVOICE TO .._--.. � _-. ET -_._..__ <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICESJ � ig- BXi.D <br /> 10624 OLIVE AVENUE,OAKDALF,CA 95361 ='V-,_. � � —-�- -I-- " <br /> OFFICE-(209)947-8757 °� z°1 3C.oNTACT .__�____._...___............... <br /> 5� d <br /> FAX -(209)847-7744 PH# ---_ ....�._.._._......_._ ------ <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING OB# ......._...__._....__ O # _______PO <br /> "u1,I I 1'II 1 11 IIIIIi 111,11i;' 'I'° l I,qi {'{{ I ly I I II c;',3 i[1[[I!` [i'II,IIII VIII 1111'11 III '' `'°IE II I,ilalllil 9,'II'1 I kl"E1EII!I!1!II!';k'I IG!i, LAB.ANALYSIS REQUE9= SITE SAMPLING MAP <br /> 11,1a1'i"��ill II'I'i,l Idfl, I'lli,i�k1,�1,I, 'llillll Elllrtlli Illlli 1,11 I€Il!Iflll I�I II I 1171 �I li li4h [[f,h ! ��� E€�� �d � <br /> CLIENT- CONSULTANT fiellpowvc ' * plowm <br /> SITE NAME PROTECT po 1 ' ♦ i R`�� <br /> ADDR o D a CITY ADDRESS d ST F ° � r � - 10 <br /> SAMPLER SIGNATURE �' T O e p c aQc <br /> SHIPPED VIA wAYBn.I. ----�- a e o e e b <br /> ANALYSIS BY TURNAROUND TIMEDAY W w ado a) Rl <br /> CONTAINERS 77PE MATRIX 01,l 'I if' d 'I IIILi'I lillllll ii illi I!I' i 'EII II Illi III II REMARKS/LAB LD <br /> ,IIID SAMPLE LD f DA TZ TIME <br /> 1) V - <br /> 4) <br /> s) v <br /> 6) <br /> 7) L <br /> s, <br /> 9) <br /> ID, <br /> 11) <br /> 12) <br /> 13) <br /> 14.) <br /> IS) <br /> � rTa� S PLE INT C COND ION <br /> oulBY <br /> mxvvmB, RECEIVED COLD&INTACi' !M&ej NO <br /> RBCEA D BY ° C.) ALR DURBLES IN V O_A 5 / YES( NO LINE(S)#� <br /> REL34QUIWMBY / e� CUSTODY SES INTACT I YES ✓ NO{ NIA <br /> oO ALDA1ElTAf6 <br /> IV <br /> RECEIVED BY MESFRVATIVBSUSED 1 YE NO <br /> RELe4QUt%W Bl L <br /> r Lsloru�uRet <br /> NOTLE <br /> E PLEASE ARCHIVE THE SAMPLES SU8MTPIED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE * IM T B E,TAME,E T B L,D I P E,TBA) <br /> B B =BAILER BI ANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br /> PINK FIELD COPi WRITE A S FELON TO LAB WITH SAMPLES 1 E LOW RETURN TO CL)ENT W ITH RESULTS DET-TECH C 0 C FORM 95 <br />