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-- ANALYTICAL REQUEST/SAMP . CHAIN OF CUSTODY -- LAB-TRACKING #: ----------J <br /> RECORD OF -T� DATE RECIEVED: --------- — ----- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 -- ---- �v�__ /� G 1- ----------------- —--- --- - <br /> OFFICE-(204)W-8757 <br /> FAX -(209)847-7744 i'Ii.a ( )T�3wr o ' CONTACT: --- <br /> CALIFORNIA CONTRACTORS LICENSE#657366/CLASS"A"ENGINEERING <br /> OB# --------------------I OICE#-----------P.O.# -- <br /> IIf!'' I !1! I i I !i I IiIIII;iiulkPl I 'i I fl jil I Ili;III"i{I`liifilil I I' i i'I I I hi,li IIII'i <br /> 'l'1(li�;illlil�L�l�l;l,lhf I i f i I �I � I I I I I I. II III II,�, ��lu,,:rr+:I,illh Ii,+'LiLLlliu�l::n:ih itt�„J=1i,IIII I�Lilll�l„II I�h II IIIiI''I Iiirl�w Iiu:Ilii LA0-ANALYS4S REQUESTED SITE SAMPLING MAP j <br /> CLm,rr. •W ANT: <br /> * i<S <br /> SITE NAME: O,fECT: ♦ WJ)5 <br /> ADDRESS W ERMA CITX: 41 y, O <br /> SAMPLER SIGNATURE m r <br /> SE3PP'ED VIA.- :'', WAYBILL#: <br /> ANALYSIS$Y: TURNAROUND TIME: DAY F F pat S'o W W <br /> YlHnrs ae COTANES X4MPLELI R . <br /> a <br /> 6 _ <br /> Ips 'tQ <br /> i <br /> Y "I�rrvfrr EY � ABY; I+ wTe I rum SAMPLE INTEGRl7}'/GOND dN <br /> REACEWED COLD k INTACT !YES NO L <br /> DE ITII� <br /> ”"RE1,d�QUEg EY:� - •- ��8Yc AIR BUBBLES IN V.O.A.S ! YES NO L[ S 8- <br /> r CUSTODY SEALS INTACT ! YES NO( 1 NIA f <br /> A PATE I TIME <br /> 1`I > RECEfMBY: <br /> PtESFLEL24QULSHMBY. VATV5 LISED I YES NO <br /> W•.. . - - - I (SIONATURQI ! V 1..•- <br /> Nom, Plpj►$E AACHIVE THE SAMPLE'S SUBMCITED FOR THE PULL HOLDING TIMI?ALLOWED,UNLESS OTHER AAAANGPJNENIS ARE MADE. * (M.T.B.E.,T.A.M.E-,E.T.B.E.,D.I.P.F.,T.B.A.) <br /> y.• H-S.=BAILER BI BLANKS COLLECTED IN THE FIELD. <br /> F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br />��•- - ' s.. PINK•FIELif COP1•- WHITE i[YELLOW-TO LAB.WITH SAMPLES 1'ELC.Ott'-RETURN T(1CLIENT WITH RESULTS DF_I-TF,CN C.O.C.FORM 98 <br />