Laserfiche WebLink
Ir <br /> I <br /> -- ANALYTICAL REQUEST/SAMPLE CHAIN OF CUSTODY— LAB TRACKING # ------------------- <br /> RECORD OF = DATE RELIEVED ------------------------------ <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES LAB INVOICE To _ ,—__________-_.__-.---.----_.--.__-�-=------- ----------_-----------------__ <br /> 10624 OLIVE AVENUE,OAKDALE,CA 45361 .................�.. -.— <br /> S <br /> OFFICE-(2"8474757 <br /> ------^' ------------------`-------=--------- ------ <br /> CALIFORNIA <br /> -�zo4)X7.7744 PH� �.._._.--�-)--:.__. � CONTACT <br /> CALIFORNIA CONTRACTORS LICENSE#6573661 CLASS 'A"ENGINEERING , f: E 'tet <br /> OB# INVOICE#------------------- P O # - <br /> I <br /> r rr Erlr r li I i it I I I it u I Ir r <br /> rlui tt rr t' r i rnilu }i <br /> LAR.ANAtYsls REQUESTED SITE SAMPLING MAP <br /> CLIENT C b�v � ip e4 3 CONSULTANT ;7- ' � a — (MaTM <br /> og <br /> SITE NAME PROEGT sw t + -. r tR "t 4 :,� -r <br /> i rT'MQ1 `'- CITY 'res`4.. d A� 5T <br /> ADDRESS ,„ a <br /> SAMPLER SIGNATURE <br /> SHIPPED VIA a WAYBILL# ' <br /> p, ww e <br /> ANALYSISBY � M s TURNAROUND TIME y i-k,.QQ i e DAYS Iw F W w allo f i7 ��'>1 °F ' <br /> I SAMPLE LD IDATE TIME CONTAINERS TYPE MATRIX I ' II <br /> REMARKS I LAB I D <br /> k <br /> 3) <br /> r <br /> E) �;� ri'�M• � i �� a � i � t r <br /> c <br /> g) y-.i',- Yr" x 9 a,�R 3 � H Y 3 ✓F n e t1 a{xS <br /> 9) <br /> il) T <br /> 12) <br /> x <br /> 13} r" <br /> 14) <br /> LS) yid a <br /> RE1 Qi0LI5Hm B5 t s oAg)TWE <br /> ; �ay 1 y SAMPLE INTEGRITY 1 CONDITION <br /> I14-" - (SMA7UR67 RECEIVED COLD&INTACT 1 YES f I NO f } <br /> i A <br /> nfl nvqu]sttFD et �; r d f' RECEIVED BS DATE AIR BUBBLES IN V O A S ] YES ( NOF fLIN S R <br /> K <br /> tsKmQm <br /> (SICNATBRE) `!rs CUSTODY SEALS INTACT 1 YES f°p! NO f I NIA f I <br /> 1 DATE rnmE <br /> RELJNQUis WR) RFMVE nY PRESERVATIVES USED I YTS NO <br /> 7 {56(37SAT[JREI 1 V S Y <br /> VOTE PLE4SE ARCHIVE THE SAMPLES SUBMITTED FOR THE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE � (M TM E T.A M E E T B E,D I P E TBA) <br /> B B =BAILER BI ANKS COLLECTED IN THE FIELD F B =FIELD BLANKS COLLECTED IN THE FIELD <br />