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r-7 71 <br /> -- ANALYTICAL REQUEST/SA HP )CHAIN OF CUSTODY-- LAB.TRACICINC #: ------------=----------- <br /> RECORD OF DATERECIEVI?D: `-�.`-z <br /> io <br /> DEL—TECH GEOTECHNICAL SUPPORT SERVICES J B.INVOI Top: �J'—�' — - �. �.. <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95MI - Q=ka+�-* --.. 4A--b`p-a*���-�..-_. <br /> OFFICE-(209)847.8757 Q �o��,p ) /► <br /> FAX -(209)847-7744 PH.# ( - a.4%.- M)MONTACT: --- ----- <br /> CALII ORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING OB# ----------INVOICE ....... <br /> illll: :'''!'il!i,l' II fl ,III :;l` !il!l,l !i!i dill illi II.i.:i•; `' 111 iil it I I l..Il l' ili 1 As ANALYSIS u>�>eD SITE SAMPLING MAP <br /> VIII,I!f I, E ! '!.II l l'lIli!l 1, I,I,II , If Il I "I I � <br /> CLIENT: 'fFCONSULTANT: Ylih(OAM I * <br /> SITE NAME: PROJECT: , ;MQ � >1 <br /> ADDRESS: CITY: ST.: 8 <br /> SAMPLER SIGNATURE: , <br /> SHIPPED VIA: AYBILL#: °° ] °�° o0o F <br /> ANALYSIS BY: TURNAROUND TIME: lvDAY �". W Ew %So W W <br /> !f'1 SAMPLE Iff 0` DATE TIME CONTAINERS TYPE MATRIX REMARKS/LAB.LD. <br /> ll�. 3 1' fll l l <br /> 1.J <br /> 2.) <br /> 3.) ' <br /> 4.1 <br /> t <br /> 5.) <br /> 6.) Lf <br /> 7.) VIC <br /> 9.) 1 <br /> 18.) <br /> 3 LJ <br /> 12.) <br /> 13.) <br /> 14.) <br /> 15.) <br /> RFLINpU1SHID BY; of fjA <br /> RECENED BY: / SAMPLE INTEGRI /CO A aN <br /> DA <br /> L <br /> (51dNA'[VRE] O RECEIVED COLD&INTACT/ YES NO i <br /> DA /nME <br /> RELINQu15Ht9)BY, `Q)!rJ RECEIVED BY: / x`o 0 AIR BURBLES IN V.O.A.'S /YES NO C LTMSk- <br /> �� ' ! CUSTODY SEALS INTACT / YESNO( NIA <br /> ! DATE!'14,fE <br /> IV <br /> RELINIQUISI�BY: RECEED BY: PRESERVATIVESUSED ! YES NO <br /> ! (5IONATURE) 1xmOIVV <br /> NOTE; PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. (M.T.B.E.,T.A.M.E.,E.T.B.E.,D.I.P.E.,T.B <br /> B.B._BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECrW IN THE FIELD. ' <br /> PINK-FIELD COPT' W HITS&YELLOW-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DEL-TECH C.O.C.FORM 99 <br />