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X06'`2 o C0. <br /> -- ANALYTICAL REQUEST/SAMP CHAIN OF CUSTODY — LAB.TRACKING #: ----- - - ---------- <br /> RECORD OF DATE RELIEVED: <br /> LAB.INVOICE TO: — - � <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES - -- --- <br /> --- ---------- <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 _�b ou v '� ----- <br /> OFFICE <br /> -.OFFICE-(209)647-67SI <br /> FAX -(209)647-7744 1 PFL# (!_-__1.)%� MI CONTACT: -------Y-----------------------�...---.__.___-�..�_ <br /> CALIFORNIA CONTRACTORS LICENSE#657366 I CLASS"A"ENGINEERING <br /> OB# -- I DICE#--- -P.O. - <br /> I rI;Irli�L�,i� �.i,rrjui l EIIII.I I)I! All 1id.•' 11 [ I i <br /> LAB.ANALYSIS tn 11E rI f1 iSITE SAMPLING MAP <br /> CLIENC: V, %W4 CONSULTANT: <br /> SITE NAME: OJECT: >; i yl W <br /> ADDRESS ► CPTY: � ST: t F G a 1T�N <br /> IV <br /> SAMPLER SIGNATURE: +�1 0 p o R [-! o 'r, 1 <br /> SHIPPEDVIA: WAYBILL#: pC pC d a d d <br /> ANALYSIS BY: TURNAROUND TIME: DAY(S) w uo W W <br /> s MPLEm• DATE rLVE CONT"NERS TYPE MATxlx �!I�li ,19 !il �i, i I i i I REMARKS/LAB.I.D. <br /> ,a 1-7 p 6 - <br /> 2a C — -7 <br /> Z.o <br /> 4a <br /> sa <br /> 6.) <br /> �.1 <br /> ea <br /> 9a <br /> 10a <br /> 11a <br /> 12.) <br /> 11.} <br /> 14.) <br /> ISa <br /> M <br /> - <br /> RL��sY. / � SAMPLE INTEGRl7 X/CONDITION <br /> RECEIVED COLD&INTACTIYES NO ( <br /> r <br /> RELLNQUTAaF�BY: RBf�1Vl-�SY: AIR BUBBLESlNY.O.A.'S / YES NO LI S Ir- <br /> 1. a <br /> p dQ (S10NArJM r CUSTODY SEALS INTACT ! YES f"")' NO( NIA <br /> 0 A M f jw DATE I <br /> RELWQUISLff�A6Y: RBCEIVEpBY: f RESERVATIVES USED / YES NO <br /> r aaNATURE) r L�'� '' ko ,T;AXPEOE=5R.VAjjy&& L_ <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PUU_HOLDING TIME ALLOWED,UNLESS OTHER ARRANG ENTS ARE MADE. � (M.T.B.E.,T.A.M.E.,E.T.B.E.,D.I P.E.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLEC M' IN THE FIELD. F.B.=FIELD BLANKS COLLEC O)IN THE FIELD. <br /> PINK-FIELD COPY W HITE A YELLOW•TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DF,I,TE CH C.O.C.FORM 99 <br />