Laserfiche WebLink
m --ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY LAB.TRACKING N: --------------------------- <br /> RECORD OF � DATE RF,CIEVED- ----------------- <br /> - . <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE TO: ------t--!_lY..i�f..l�----�����---_-----------------------�-- <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ...............--_........--.............--._.---..........._-_........._..—-------_..---------------...----....... <br /> ......__. <br /> OFFICE.(209)817• 57 <br /> FAX -(209)517- PHX CONTACT: ---_--_. --.--_--.---------- -. <br /> OCAM' NIA C L LIC E CLASS"A"ENGINEERING <br /> I I,'i ' ! I I ', ` li. I �I!h LAE A JQBf . LYSIS REQUESTED(PLEASE PRINT) SITE SAMPLING MAP <br /> CLWXT, CONSULTANT: <br /> *E: PROJECTc , <br /> ADDRESS: <br /> u t C3. <br /> .;. <br /> SAMPLER,SIGNATURE- <br /> VIA _ WAYBILL 9: <br /> ANALYSISBW TURNAROUND TIME: DAY( O <br /> SAAl1'1B LD./ DA78- 77A(8 CONT INBRS TYPE MAT= - li.I irl lL1 '"I 'ISI ? I' Irr illi REMARKS/LAB.LD.#`S <br /> 44 <br /> = sa' = 5. <br /> p <br /> +_ - <br /> 12) a 11 11D <br /> `t_ V <br /> 1TIME <br /> man_ <br /> SA <br /> ll y <br /> MPLE'INTEGRITY/CONDITION <br /> ti' RT = TU n RECEIVED COLD R INTACT 1 YES NO <br /> DAIZInME <br /> 'RBCFIVEDHY. <br /> Alli BUBBLES IN V.OA.S I YES NO LI I- <br /> _ CUSTODY SEALS INTACT !YES NO( NIA <br /> DATFrnmE <br /> 8. <br /> 13WVEDSY PItPSFRVATIVES USED .! .YES NO f - <br /> L _ <br /> " SICiNA7URE <br /> NQL&FPIBASSAit SAM_pm5>;ImnnDPOATItBP MLWLINNOTIMEALLOWED,UNLESSOTMARRAN' ME INA17. <br /> a BA 1""�' [1 TfIP ('.8 BfL 1.1" IN D. <br />