Laserfiche WebLink
SAMPLE CHAIN OF CUSTODY RECORD <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLE'ASF: PRINT) Lab. Analysis by <br /> 10624 OLIVE AVE- OAKDALE, CALIFORNIA 95361 LAB. INVOICE TO : - <br /> OFFICE (209) 847-8757 <br /> FAX (209) 847-7744 ) RECORD OF-- OF 2- PH.# { ) <br /> CLIENT 1 CONSULTANT: C_-� .-1.i 4:L t, P.O.#I INVOICE # <br /> r <br /> ANALYSIS REQUESTED.. SITE SAMPLE MAP <br /> PROJECT I SITE NAME: �� , , "; (c y., r-+ I g- i 1 (ITEMIZED AND CHECKED BELOW) A.ar ro"aw <br /> (NORTII <br /> n c/) <br /> ESTREET; .'` /�^�s- -) t a m z C <br /> CITY: f .STATE: o v < ¢ ¢ <br /> C. <br /> --------- �._.w. .-. o o¢ <br /> ff` T j 'o U co u J <br /> HIP VIA: y 1 o s ¢ _j a , <br /> r '_ ' ,. WAYBILL q +3', w ¢ c`a <br /> SAMP'CER:(PRINTED s1cNATVRE) <br /> uj <br /> SAMPLE LOCATION DATE TIME NUMBER TYPE �q�ypyP LD o =w �. o v. o L, <br /> OF (CRAB Oj <br /> x = -0- F. v 1— J <br /> (IDBMIFICATION) MT6JDA3%YR. HOUR/MIN. Q�NYAINERS �MPour MATRIX 1 a m co co w F_ REMARKS/* SPECIAL INSTRUCTIONS BELOW <br /> Ix <br /> 2.} <br /> 3.) <br /> 4.) <br /> 7.) 4"r' <br /> 8.) S 1 <br /> 9.} <br /> I O�) <br /> :� �� S 1 �, 1- 1 i;�; ••S4FIFLE IMEGRITI'1 CONDITION A TURNAROUND TIAfE •• <br /> iT„l' t F.` , RFA'EIVEU COLD&1NTA('T I YEA �J� %.oRELINf1LI1SIfED H}';i�F¢,nxn )ATE!1'IF1E t!i �.r'�) uF:CErvE11 B1':s�I:�.rr,�• ATE I TIME,,/ PRESERVATIVFS USED <br /> CUSTODY SEA S INTAC-T I YES c , .f, c NIA y') <br /> AIH HIHBLP: IN V.CI.A.'S f VF'ti Nn�;r"� LIKE:x <br /> RELINQUISHED B7":nv.r.ruku IA1'$!'1'Ih1 F.: RF;('F,�[Vp[f H5':su:�,rvxc• IATF:f l7ME: <br /> TUNA'ARUUND TIME. CHECK ONF <br /> KE:I,IVI)l'Itill};U ktL,a...n.�. I1;�'I'kdll?11'.. X)'.T1'.lI'I:II 111'/,•I1N1 N;11 UR)'.,..n; nLn.e�.�,.u.n,in 1ATE/TiAlE: :d. irtwtt { ", . I(11'R } . .UAP <br /> I' <br /> NOTE; LABORATORY SAN11'1_E ARCIJIVING WILL BF;3II DAYS FR(OI THE [)A,rF SAMPLE H'AS CO[.I,ECTE1),UNLESS OTHER ARRAI-.N'(;F:\9FN"1'S ARE MADE. <br /> PLFASF RFT[ ')F 1,-TF,CH'S ICE CHF-ST AND BLUE WE AS S(K).N AS POSSIBLE . THAM` c ]WI, FOR.-NI C.O.C. <br />