Laserfiche WebLink
-- ANALYTICAL REQUEST I SAMP ' CHAIN OF CUSTODY LAB TRACKIN! <br /> Lia <br /> RECORD OF DATE RECTI <br /> LAS INVOICE TO --- Ll "_ - - <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES t • = ��- <br /> 10624 OLIVE AVENUE,OAKDALE:,CA 95361 <br /> PHOFFICE-(2A9)847-5757 NTACT } <br /> FAX -(209)847-7744 <br /> CALIFORNIA CONTRACTORS LICENSE#t 6573661 CLASS"A"ENGINEERING _ _ P O-� <br /> pB# —INVOICE# <br /> 1 11 I i QUI l[ I '�!I'I 11 ' !!!III 11 I I1tEi II' .'I ill II If 194 f'ff19E1t11E{! ' Il€ii Ii I i <br /> LAIL ANALYSIS RLQUFSTLD(PLEASEPRINT}- SIT&SAMPIIfflgM� <br /> i = Illlll'I� I! lel'III I n I!I Illli II Illli(�I�,II#=I,�,I,II���!I�Ilil91!filllf�il6lflll°II,III�I i IIIA;!!II � II IIl�lllll IIICII,I,I,I ,III 111 II,{I��E�I��i,��l II I Ililillll�„I,!,I,ii,I�, E�1 IIl�II��i IEI�=Ii�IJ'lll h <br /> �CLIEPFP: CONSULTANTT <br /> SITE NAME- PROJECT. <br /> 711 3T <br /> ADDRESS CII Ys _ <br /> SAMPLER SIGNATURE <br /> SHIPPED VLA: WAYBILL# �-- - - <br /> _ <br /> DAY(S) <br /> = <br /> ANALYSISBY. TURNAROUNDTIME= <br /> IIlIji SAMPll I II# IIATE TrarE caxrAnvBRs TYPE atATxi� I II ! 1111111 Ifll II VIII III IIII, Ill III 1111111 i�1 EIII i'IIIIIIII IIllllli� _ REMARKS LAB=LDY5 <br /> v4� <br /> ;t? _ <br /> 2) -,. <br /> � - r <br /> 5) <br /> s) i! � <br /> 4} <br /> 1l) <br /> 12) <br /> 13) <br /> Ib) <br /> 15)15 <br /> ATE TIME <br /> DATHI Limp SAMPLE INTEGRITYI CONDI770N <br /> RfiT.NOULSHEC ' 3L ,r't� RECF3VED BY '.` J -t <br /> ! (j D'� mfr If /1 RECEIVED COLD&WrACT 1 Y ) NO f 1 <br /> 1 (SEGNA'i'[fREI <br /> -4;A <br /> Dw TIME �� DAMrnmE ABR BUBBLES IN V O A'S !YES f NO LTN S It <br /> RELLNQUISHFD BY FXCC13VED BY /' <br /> I CUSTODY SEALS OYI'ACT 1 YES ( ) NO( 1 NIA <br /> (SIGNATURE) f 1 <br /> MEMODATEITIME <br /> 1'RESERVATIVESU5ED ! }ES NO { <br /> R=WNQUISHIEDBY RECF7.VFJ)BY <br /> (SIGNATUREI i TY C)EIMUMV TJjFfSj <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUOMIITED FOR THE PULL.HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD F B =FIELD BI ANKS COLLFCIFD 1N ME Hrl a DEI IFCI(e ea e I oRnt <br /> PINK FIELD COPT lk%IHTE&1 EI I()H TULA.B «ITH S4kn1PLES 11:11 0" RFT'tIRNT[iCI IF.NI N ITTI RFSIII TS <br />