Laserfiche WebLink
—ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY-- LAB-TRACKING #: - <br /> RECORD 4I' DATERECIEVED: <br /> LAB.INVOICE TO: " -- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES -€ , 5 <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95MI <br /> rl <br /> OFFICE-(209)847-8757 _ Zir��' `-� -- <br /> FAX -(209)84'1-7744 P$# ( CONTACT: - Tyl <br /> CALIFORNIA CONTRACTORS LICENSE!6573661 CLASS"A"ENGINEERING B# INVOICE# p Q# b <br /> l" IlttFFf!klli ' 'ur Hu1j E€ !-- `!I!: '1''s'••,rw;.,:q1 I;1' i I-- I ..I I!I {IrI:'IIPIIII`1 I I II,i +'Ep'E€.I IIIII li .g;'} 11a"]"Iiil,t.11i I{�il'lill Ilt{1-F`I�il II!��:fl k{j{eI <br /> LAB-ANALYSIS (PLEASE PRI1'f SITE SAMPLING MAP <br /> Ii���)I�I!Iltllll�������SII�III��II�li@t3=Ftt111lrtt;i�l�litk.:;lily:,klrll�3`.X11±f:'tff,`if�lli,l���l�lil�lll Ill�t�iI„��,I;I���Iflf}I if�l#1)IIIi�1III�II�lillli f,fl�E li�l illIliill�::i;l�3�ilifiifkrl-1 J31{,I�::III��rliillilll�,lilElAllifli s{.i <br /> �actta <br /> CLIEkr 1, CONSULTANM <br /> SITE NAME }� PROJECT: <br /> 43 oc <br /> ADDRESS: NO r CITY: ST.: uj 1ai-a <br /> SAMPLER SIGNATURE U T <br /> SWPPED VIA: Com, WAYBILL#: d <br /> ANALYSIS BY: 7 TURNAROUND TIME: DAY(S) <br /> 'I i�lll IE' I Ii It ! l4tkkF” j I II I 1i;{III i <br /> '11111{"' REMARKS/LAB.I.D.#S <br /> SAMP ID.I DATE TIME CONTAINERS- TYPE MATRIX <br /> 1, 6NAAL Z <br /> I z) <br /> 3.) <br /> s. <br /> 4.) -. b Z <br /> 5-) Spa- 6 t5'� <br /> 6.) ' <br /> 9.) <br /> t t.) <br /> t 2.) <br /> 13.) <br /> 1a.) <br /> I5.) <br /> DATE!n —DATE 4� R�EgCEIVPTD <br /> PLE INTEGRITY/CONDITION <br /> 1[1[rr RECFIYED SY: <br /> REDNou1sHFD BY: <br /> yslcrrwrURsy / $ENTACT 1 YES DATE <br /> =F.ELJNQUt.SH—EDBY 614 A RECEIVED BY: ACR t3U BBLFS[N V.O.A.'S <br /> f (s1GNATUREI LCUSTODYEALS INTACT I YES NO[ 1 NIA f <br /> DATEITiME DATEITIMERELINQUISHEDBV: MZOVEDBY: IVE?SUSED 1 YES f NO <br /> {51GNATURE1 rV S: <br /> NOTE: PLEASE:ARCHIVE.THE SAMRIPS,SUBMITTED FOR THE Ptll.L 1101-DING TIME A1. 0M`10,k'NI.ESS OTHF,R ARRANCF AENTS ARF.MADF. <br /> S.B.=SAILER BLANKS CY)t.[.GC'17?1)IN NFifi 1'[F,t"E). 1:B.=1:11:1.1)BI.ANKti['C)I.1.1E('"Ili/)IN"1'131.111?E.[). <br />