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9901040522 DEL-TECH—SVC SAMPLE CHAIN OF CUSTODY -- LAB.TRACKING #: ---------------------------- <br /> 1 OF 3 DATE RECIEVED: •.••........................... <br /> 01- LAB.MVO TO: �J_]y,:J................... <br /> GEOTECHNICAL SUPPORT SERVICES r,^ { �`��p G j <br /> 10624 OLIVE AVENUE,OAFDALE,CA.95361 ... 1 ..�..L.Y.T. ..----• - idl r_.. ..._J. �!__-- <br /> OFi:-ICE-(209)847-8757 ��` 7�- j <br /> FAX -(209)847-7744 PH.# ( )Sq <br /> ONTACT: .................................... <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> OB# ------------------INVOICE#----- -------------------P.O.# ......-........_....................—... <br /> i i'f'Ijlljllpil;llljll' . 'I II II j I l'jl!{'fi!I'Ijijj'Y!C�illlilji!'II VIII'i I" !! i i,II'Il:il!fh }1Ij r' 'j"illi'II I' �i'il I Il j fl 'i' j''III' I I`I tl I'lalllijji LAB.ANALYSIS REQUESTED <br /> II,:L.Ifd.,,a,,,I..III::I}:,�.�I,Illll:ll,:�,hl,ll!III,11111,[11.P;IIIL:I�,IIf,,If1,��11:11111,IL:,:l11l,Illf�dl,ll,Illl,l,l111::111111!1111111I�1lr41.:1111lIIIll:lfl�lldl.l!„h„I � SITE SAMPLING MAP <br /> {HORTIq <br /> CLIENT: CONSULTANT: <br /> SI'Z'E NAME: PROJECT r <br /> ADDRESS: a CITY: <br /> SAMMERSIGNATURE: a ui o <br /> SHIPPED VIA: WAYBILL#: <br /> ANALYSIS BY: TURNAROUND TIME: DAY <br /> P�f a+ DATE r7ME CONTAWERS TYPE AIATArx III IIII 'I 111111 iu111111'!!l i!f i I III 111111 VIII I II I III II Ili!I1 illilli REMARKS/LAB.I.D. <br /> I 2.) * ;� <br /> 19 3.) N11-Co bE2 <br /> Z <., - �Z ��5 3 <br /> 5a —i �. �! <br /> 6, 7 <br /> 7.) <br /> 12-1 _3Y7 <br /> 9.) lh L 12A 21 3 <br /> 1-9 <br /> a3 1I, P)h 3 v ] <br /> �p I2.) 1 -:1 <br /> �)q 13-) ' 1 <br /> •4. 14-) M 1 - /-2/,:3 :2 <br /> 15)=Ej p 1 15 2/ <br /> REL N*tJ W 5Y': 1 �]A RECFISrID BY: t#D.,AT-E <br /> I SAMPLE INTEGRITY l CONDITION <br /> �� {s:t7tiAT[It RECEIVED COLD k INTACT!YES ) NO f ) <br /> A AIR BUBRI,T-_S IN V.O.A'S ! YES 1 (SIGNATUREF CUSTODY SEALS INTACT ! YES f NOf I NIAA REUNQulsl�var: REC.IVEDBY: � PRESERVATNESUSED J YES )NO ( <br /> 1 (SIOtUTLRflO V `—� <br /> NOTE: PLEASE.ARCHIVE THE SAMPLES SUBM17TEOFORTHE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS AMMADE. <br /> B.B.=BAILER BLANKS COU.ECI•ED IN'I HE FIELD. F.B.=FIELD BLANKS COLLEM- u)IN rim FIELD. <br /> PINK•FIELD COPY W111TE&YELLOW-TO LAB.W"ITIISAMPLES YELLOW-REETURNTOCLIENTWITHRESULTJ <br />