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-- ANALYTICAL REQUEST/SAMPTE CHAIN OF CUSTODY-'- LAB.TRACKING#: <br /> RECORD OF DATE RECIEVED: <br /> DEL—TECH GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE TO. --- <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ---------------------------------- ----•----------------- _. <br /> OFFICE-(209)8474757 J, <br /> FAX -(209)847-7144 PHA { -------»--------------CONTACT: .--------.. y <br /> CALIk ORNIA CONTRACTORS LICENSE#6S7366/CLASS"A"ENGINEERING <br /> OB# --I OICE# P.O.# ----- — — <br /> I, LAB.AKALYSIS REQUEn SITE SAMPLING MAP <br /> I II1 I;I <br /> CLIENT: CONSULTANT:" ai _ -• a ?m '� -"�. x <br /> SITE NAME: PROJECT: I >; <br /> ADDRESS: C cirrY: ST.: <br /> SAMPLER SIGNATURE: % e o <br /> - <br /> SHUTEU VIA: WAYBILL,#: x d a Q E <br /> ANALYSIS BY: TURNAROUND TIME: DAY : a W k7 <br /> Illi SAMPLE ID.I DATE TIME CONTAINERSTYPE MATRIX ' , 11 I ,I, , . 1j.1REMARKS/IAB.ID <br /> �) <br /> i4o1) <br /> 6)�.J <br /> — <br /> 7.) ELM Pm <br /> g) - �ZZ <br /> J�ID <br /> u <br /> 3 <br /> 9) — i <br /> Anli <br /> -1'54d <br /> 12) <br /> l3.) 14 .Q <br /> 14.)sI ) <br /> 7► <br /> I5.) oil <br /> I,r <br /> �1 s:r BY- n DATA r SAMPLE INTEGRITY/CONDITION <br /> ARF]..R+iO'DLSEIFD 8Y: ffp f or <br /> j f]f♦ /^ '7-/y <br /> {SIQNATt:1�l !• l- f�/ '` Y e• f!1� / REC6[VEd CALp 8c INTACf' J YES NO <br /> RELINQUI811% RBCErvID BY: AIR BUBBLES IN V.O.A.'S J YES NO LI S #- <br /> J (S)ONATVRE) CUSTODY SEALS INTACT I YES (,4' NO( NIA ( <br /> A DATElTBN£ ' <br /> RIE I NQUI MIRY, aaeFsvm BY: PRESERVATIVES USED I YES NO <br /> r (SMATURE) , TYPE OF PRESERVATIVE(S); <br /> NOTP: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIMP.ALLOWED.UNLESS OTHMR ARRANGEMENTS ARE MADE. <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=FIELD BLANKS COLLECTS)IN THE FIELD. <br /> PINK-FIELD COPY WHITE&YELLOW-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS DFI_•TECII C.O.C.FORM 98 <br />