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.m - <br /> i <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB.TRACKING 1!: --------------------------- <br /> RECORD 2—OF 2' 7DATE RELIEVED: •------.-=.-- - - - <br /> FO209) <br /> TECH GEOTECHNICAL SUPPORT SERVICES LAB.INVOICE TO: •—l.t<- !w-—1 T--- =--1 - ------_----------------------- <br /> E AVENUE,OAKDALE,CA.95361 - ---------------------------- ----------------------- ------- --- --- ._... <br /> 647.6757 <br /> FAX -(209)847-7744 PH.IY (------------)-------------------•CONTACT: -----------------------------------------------------. -.----- � <br /> CALIFORNIA CONTRACTORS LICENSE 0 6573661 CLASS"A"ENGWEERING <br /> OB0 ---------------------INVOICE M--------------------------•-P.O.# --------------------------------------- <br /> LAB.ANALYSIS REQUESTED SITE SAMPLING MAP <br /> CLIENT: CONSULTANT: VEIlu AK <br /> SITE NAME: D'�` PROJECT: <br /> ADDRESS: 1 '' �.� I CITY: ST.: 1 y� O <br /> SAMPLER SIGNATURE: L_ $' °�° F' <br /> E <br /> SHIPPED VIA: WAYBILL It: -.�'•.�� �� ] e <br /> ANALYSIS BY: ' Imo. Y,� TURNAROUND TME: < r DAY tpr2" m [azt <br /> SAMPLE LD.s DATE TIME CONTAINERS TYPE MATRIX REMARKS/LAB.I.D. <br /> 4-) - i ; 1 <br /> 6.) -Y F 1 <br /> f <br /> 9.) <br /> 12.) <br /> 13.) <br /> 14.) <br /> 15.) <br /> �[)j SAMPLE INTEGRITY I CONDITION <br /> A'r1.INW[53iED BY: , 4 RECEIVED BY: �'TMVM ^ �` <br /> DA n <br /> ,.� (SIONA7lJ[t)=1 RECEIVED COLD&INTACT I YES NO f 1 <br /> 11 T9 <br /> RELL�:QI115FfED Br. '//� / '/°-.� [zrrveD BS': ! /=f yam. ABR BUBBLES IN V,O.A.'S I YES NO L!N S M- <br /> v �`/ •S �• l�/ ;h� fSYGMA"IU[ZE.) I'�'�( it-1 ` , /, ti>�f L / <br /> CUSTODY SEALS INTACT ! YES f NO f I NIA f i <br /> A DAlE 7 TIME <br /> RELINQUISHED BY: REC'EMED BY: PRESERVATIVES USED 1 YES NO f <br /> 1 (SIONA'IURF) <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL}FOLDING TIME ALLOWED,UNLESS OTHER ARRANGUMENTS ARE MADE. (M.T.B.E.,T.A.M.E.,E.T.B.F,.,D.I.P.E..T.B.A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.=1-'IELD BLANKS COLLEC M IN TILE FIELD. <br /> PINK-FIELD('OPV WHITE&YELLOW-ToLAB.WITH SAMPLES FELLOW-RETURNTOC LIENTW(THRFSULTS DEI:TErHC.O.0FOR MgB <br />