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1 <br /> . Oe ANALYTICAL REQUEST/SAt .SLE CHAIN OF CUSTODYde <br /> LAD,TRACKING #: '-----=)--•-••-•••--••-•- <br /> RECORD O OF DATE RECIEVED: .........-............. <br /> ---...__ <br /> LAB.INVOICE Ti :DEL-TECH GEOTECHNICAL SUPPORT SERVICES Oy1.�t!.. <br /> 10624 LVAVENUE,OAKDALE CA.95351 <br /> OFFICE•(219)847-$757 O . 1 ' 'IA <br /> .�- .... <br /> :-- <br /> 7)7 1 H I c r <br /> FAX .(209)847.7744 PH.# (1rJ .._) --!c�.I ONTACT: I�i� _...J-4. I -•______.CA,--- .- <br /> CALIFORNIA CONTRACTORS LICENSE 11657366!CLASS"A' ENGINEERING <br /> ng <br /> . - P.O.# ------., LAB.ANALYSIS REQUFS�]tEnSITE SAMPLING MAP <br /> CLIENT: ULTANT:SPIENAME: ECT:ADDRESS: : ST.: °� p c <br /> SAMPLER SIGNATURE: l cn m <br /> I <br /> $ o <br /> SHIPPED YIA: WAYBILL#: C9 q -{ <br /> � f" <br /> ANALYSIS HY: TURNAROUND TQvIE: DAY �.` 9 w n <br /> I SAMPI91.D_A' DATE TIME CONTAINERS TYPE MATRIX <br /> f l'il ili!1111 illlllli'If ii it Illll l! !;!I! ill!! III III Illfl'�il ii ff REMARKS I LAB.I.D.I <br /> 2.) S' <br /> 3.) <br /> Xi <br /> 4.) <br /> ,4n <br /> S) <br /> 7.) I -rco x---x <br /> 8.) <br /> 9.) <br /> 12.> <br /> 13.) <br /> I5.) <br /> RMD401JISHM BY: —��4, +� RECFrVED By! DATE 7'M E <br /> P <br /> L;t�Jl S E EGRI CONDI ION <br /> (SIONATIIREI RECEIVED COLD&INTACT ! YES No { <br /> RFLNQIIISIIED BY: RFCFIVF,D RV: DATE 1-nm F. <br />� Al2 BUBBLES IN V.U.A.'S IYBSC NO LINE(S)M- <br /> WamTum) <br /> r (SMAMIM CUSTODYSEALS INTACT I )-ES NO ( 1 NIA I 1 <br /> RELNQDISI(FS)B1': RFCEIVEDBV .Sy D'kTTF.r'MIF. PRESERVATIVES USED ! YES NU <br /> . r (SICNATVREI I�" <br /> 4 V V <br /> F NOTE: PLE-ASF AR('11IVF-1'IIF SAMPIE.S SURMI-ITF.D FOR TI[E PULL Ii0[-DIN(;7IMPAIL(1W['D.IINL(iSS U'ri[FR ARRANGPML'N1'S ARI'MAVF. <br /> (M.T.1S.E?..T.A.M.f?.,F,.T.B.E.,E).i.l'.F,..T.11.A.) <br /> B.B.=BAILER BLANKS C'C11.I.EiCIF.D INTIM [EI.T.). I:B.=HELD BI.ANKS('0LLF.(7FD INTI[F <br /> PINK-FIF-LD CCPV N'HITh:h1F:LLf 111' TI'1 LAR.WITH SAMPI.ES 1'EI.Low-RETURN-r(II-LIENT W'i'm RFSI4:rS <br />