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SAMPLE CHAIN OF CUSTODY RECORD <br /> DEL-TECH GEOTECHNICAL SUPPORT (I'f.f:ASI, f�RIN!') Lab. Analysis by 4s Vii' <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 LAB. INVOICE TO : �- <br /> OFFICE (209) 847-8757 <br /> . # <br /> FAX (209) 847-7744 , RECORD OF _- PH ( <br /> CLIENT 1 CONSULTANT: =;,s= �= ? y _. � ? ' --- <br /> - - P.O. #/ INVOICE # <br /> SITE SAMPLE. MAP. <br /> ANALYSIS REQUESTED ! <br /> PROJECT/SITE?SAME: , i2('\;i j !Y (ITf SlIZED AND CHECKED 8£IOW) <br /> ' � c NORTH <br /> C). l!] <br /> STREET: :i? s y CITY: ' t � ✓'`J STATE �' r CC CD <br /> a ¢ <br /> O Irco C3 <br /> Lu <br /> }III' VIA: o > w m o� ! <br /> SAMPLER: eR1NT i s WAYBILL►1 ,r f tir�� 5:'~ • �5 a <br /> ( F.D S GNA77JRE) a a <0 a Q <br /> v 9) pus c0 O � !r -410 <br /> SAMPLE LOCATION DATE TIME NUMBER T}TE SAMPLE z a a ,� o o <br /> OF (CRAB OR Q r- J s <br /> {IDENTIFICATION) MTHJDA}'/F'R_ HOUR/MIN � N&RS ao�rAosrrs) TAX °� � ¢ en m co 0 REMARKS/ SPECIAL INSTRUCTIONS BELOW <br /> I.) y, .)•)" <br /> Z") 141 1 �.-� t j C ,• S/ } <br /> 3. V <br /> f\, 'V _-�?1 <br /> 'i <br /> �+s y <br /> 4. ^ 1 Ct ! I <br /> 5.) '"v{z�.`� - ' Is ;3j i s•r�' �' i F i i <br /> I i 1 <br /> 14 <br /> 3 3 i <br /> 1 � <br /> ^SAMP1E IATEGRTTY1 CONDITION&TURNAROUND TIME <br /> + S <br /> L. ! tl i •�C.. �. <br /> ��`5:• ( %;L.: 1 .• RECEIVED COLD 3 INTA(-T f 1'Eti <br /> RELINQUISH e`4l:+s�:w n,xu )ATF.1 TIME:s :i�%RECEIVED BY:rsi,:.wsuke� �• y <br /> ATF.!TIME: 1'RF_.VftVATIVF_S USED',-ra' )� YEs �4 N0 <br /> •� CUST()I)1 .SKAI,INTA(i 7 YFS ( Nf: NIA ��•�� <br /> AIR FII'RRLF.I LN Y.U.A.-S / YF� } N+,;�r+ } IJ INE F <br /> RELINQUISHED 13N.:no-:>,n nuc. PATE/TIM F:: RE(-E]1'FIl Hl':�xn:+eri'wr., IA1'E!TI ME: <br /> TURNAROUND TIME: (YIF.CK ONE <br /> lilVEP 10'LAB o K:17(M)':.,..... n r....�,i..w,nm. � IA'I'F.I TIME: - 11(11 rR � � 411. 1111 t:R � ) . .1141' � � I[I-uA,. <br /> NOTE: LABORA_ "TORI' SA?1'IT'LEi ARCHIVI'N'G WILL 8E 30 DAYS FRONS THE DATE SAN71'LE %VAS COLLECIFI), UNIXSS OTHER ARRAINGEME.VFS ARE NIADI:. <br /> 1'I.FASF REIT' DEL-TFuj's ICE cm.;, 'I'A\'I) BLUE 1CF AS S(LX)1 AS Y()SSIBI,F, . THAN I1; 1) <br /> f;1.-' l F()R19 C.().C. <br /> - __�. - ��_ —�_ �.--,� 1-�_.,... --._I„ _---�-.L , �r.�—� h� r,� „ �il,��-.-�r'!, rY1 ,,�' '��,�i �+ Ir ���.-,�r .•in..'�T�r.��h. -- --. ��..�. __ <br />