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ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB.TRACKING #: --••---•---------------- <br /> RECORD OF DATE RECIEVED: --/ - <br /> LAB.INVOICE TO: - ----- ---- -- -- --- - — -...._------- ---------- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES �} �y ; <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ._ �'"`� ._...+ ' ' .!.. h F`_ _--------------_--- <br /> FAX -( -(209)-77-8757 �� ' <br /> FAX -(204)847-7744 PHI -----------) ------�-----CONTACT: ------- ---- .__---------------••--•--•---•-•----••----- , <br /> CALIFORNIA CONTRACTORS LICENSE#657366 f CLASS"A"ENGINEERING <br /> ]] OB# -------------------INYOICE#-----•------.._--__._-..___P.O. <br /> I;l.r-r,I�iai�illll Irl .li.r�ili, II,;IiI [II�Ii flrU I�rgII r I I!r:rr,II li.I iI. rI III!�N,;,11 I 11 IfG II�.I. IIE, .+i rs l.rrrr r .,j,. r r.iIlrIl rI f . I I # ----------------------------------- <br /> ,. [ABANALYSIS REQUESTED. . iI ��TF <br /> SAMPLLNG MAP <br /> CLIENT: V ! CONSULTANT: y� <br /> SITE NAME: A ry <br /> JECI <br /> ADDRESS: 1? CITY: 4.'>'T6� �� ST.: 1 b F O Clj <br /> SAMPLER SIGNATURE: rr� O o r <br /> sIQPPED vIA: L . WAYBILL a o3 ^ <br /> C A F <br /> ANALYSIS BY: ,�'j TURNAROUND TIME: DAY w ,�, w r <br /> jlll <br /> SAMPLE LD. DATE TIME CONTAINERS TYPE MATRIX �!lil' r III; I�� i! ��jilljl II;'L iIIil'lujlIII ,ifI111,1 ,II i ,l,';i.' Ill i <br /> I , : li REMARKS/LAB.LD. <br /> [.) <br /> 3.) - t� <br /> 4) 1 0 <br /> 6) <br /> 7) �- 6^� <br /> 9.) <br /> i 0.) <br /> S 1.) <br /> Iz.) <br /> [3.) <br /> It 5 <br /> 14.) <br /> 15.) , <br /> INWiSiIED BF: ` - DATE t RECEMEDBY: F l !'% I . <br /> \ 7 SAMPLE INTEGRITY/CONDITION <br /> RECEIVER COLD&INTACT I YES LX NO ) <br /> A If <br /> RF7'INQD[SF c#'Q. BY: r. 7 "„Z 0 RECGIVm Bt': r ` AIEH <br /> C r �i J0 ,ff' q '7 AIR HVBBLSSINV.O.A'S ! YES NO L S p• <br /> iSMNAntREi �l Sir CUSTODY SEALS INTACT I YFS ) NIA <br /> ( ) <br /> ff) NO i <br /> DATT$I T.M <br /> R�LU4Q[$91lEDBV . I PRESERVATIVES USED I YES NO <br /> TYPE 9E(SIC3IiA7l1Rk'j <br /> S: <br /> NOTE:PLEASE ARCHIVE THE SAMPLES SVBmn-mD POR THE FULL.HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE[vIADE, � (M.T.B.E,T.A.M.E.,E.T.B.E.,D.I.P.E.,T.B.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECTED IN THE FIELD. <br /> PI NK.FTF..I.nr.0PV WHITF.&vTr.fInw.TnCAltWITH SAMPfFCV9?FInW_DFTISONTAd-lI?NTWITII0PRI tt'M nCT-TcryrRnDMa, <br />