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i <br /> r <br /> r\ <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB TRACKING # -------------------- <br /> RECORD J OF DATE RECIEVED I.=Zzg =L'L------ <br /> 11-AB <br /> - <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE T - ! - ----- dim _ --- ..' 1 <br /> ((��O°� } � <br /> 10624 OLIVE AVENUE,OAKDALE,CA 95361'` _�. 'ti.1..i...�—....---- _?.E.�'":_------j-- ---��.....................�� __-�----- <br /> OMCE-(209)847-8757 <br /> FAX -(209)847-7744 PH#4[ ! _ <br /> � -- Z-HI _CONTACT � — __ �a.t..._..�...................._. <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS"A"ENGINEERING <br /> OS# <br />' i r ir'' I r li'I''loll''!�u'rl';id i!r Er`krll l,i ! I I l I!ill'llr ll - - INVOIC <br /> E# � -----..___ <br /> i, SITE SAMPLING MAPLAIL ANALYSIS RE UEMM <br /> CLIENT 11 YN CONSULTANT g * ' <br /> SITE NAME PROJECT 1 a! r <br /> w <br /> ADDRESSEkfST O_ ..,. <br /> SAMPLER SIGNATCJRE <br /> cl <br /> SAIPPED VIA -W'AYBML# at <br /> kC x d b d d E" <br /> ANALYSIS BY TURNAROUND TIME q DAY �r ° w as W W <br /> I,III SAMPLErb� DATE TIME CONT NERS TYPE MATRI% i4! ��riili 11v 1i 11�i1(II� i`r ill[ 4�'I�i �(lill![ I���l�i �I [p] REMARKS LAB I D <br /> i) .r <br /> 4) <br /> 5) . ?L { <br /> r <br /> s) ? 6i8my- v? <br /> 9) <br /> 10) <br /> i <br /> r 11) <br /> I( 12.) <br /> !3) � <br /> 14.) <br /> 15) <br /> f A DATE111ME <br /> RF.LINWISFIE7)BY xlv»BY / . it .,---- EiNy'EGRITY/CON ON <br /> (SfCNA7VREi `` j �I jilt n? RECEIVED COLD&INTACT ! YES NO ( ) <br /> 7IM6 <br /> RFiPiQU1SFIFiD B1 r RSCS VFD BY �/q / AIR BUBBLES IN V O A S ! YES NO LI S # <br /> r ` <br /> CUSTODY SEALS INTACT !IES NO( 1 NIA f ) <br /> A f DATE 17W <br /> RF1.II�QUIS1>FA Bt Rf .«'Eb 9) PRESERVATIVESUSED I YFS NO( s <br /> i (SMATME) O <br /> NOTE PLEASE ARCHIVE THE SAMPLES SUBMr TED FORTHE PULL HOLDING TIME;ALLOWED FINLESS OTHER ARRANGEMENTS ARE MADE * (M T B.E.,TA M E,E T B.E.,D I.P E_T BA) <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br /> PINK-FIELD COP1 WHITE&S ELLOl', TO LAB WITH SAMPLES 1 ELLOW RETURN TO CLIENT 1%ITH RESULTS DEI TECH C 0 C FORM 99 <br />