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`!� client <br />+ # <br /> DEL-TECH SAMPLE CHAIN OFd"s—TO/6664 <br /> Y RECORD Address ` 0WV\1,'> PAO <br /> Geotechnical Support Services (please print) Phone No. <br /> Proj. Mgr.lConlact <br /> 10624 Olive Avenue <br />' Oakdale Calif. 95361 Pink-Field Copy <br /> (209) 847-8757 Record of White tow and <br /> RetuYellow Clie-To Laboratory with Samples <br /> nt <br /> PROJECTISITE NAME: �1 1� y�,� S ANALYSIS REOUESTED <br /> PROJECTICONTRACTIPO NO.: <br /> i. LJ <br /> NAME OF SAMPLER: 1REMARKS/SPECIAL INSTRUCTIONS <br /> LAB USE ONLY.. S MPLE__-- _ ; o:_ .._-m NUMBER <br /> LAB I.D. 1.0. ATE TIME o CON- <br /> `. V TAINERS <br /> Lim rJ- LL <br /> i <br />} <br /> •T•I <br /> 7 - <br /> 1 <br /> RELINQUISHED BY SIGN DATEITIME RECEIVED BY SIGN b TEITIME RECEIVED FOR LABORATORY <br /> s <br /> J°� BY(SIGNk DATEITIME <br /> RECEIVED: <br /> COLD AND INTACT OTHER PRESERVATIVE DYES *0 <br /> LID OOTHER: <br /> TURNAROUND TIME:''..- <br /> SHIPPED VIA: OFED X ❑UPS THEQ~•L_:NtVtV SHIPPING ORDER NO.: 024-Hr 02-Day 05-Day `Wjo_pay ,- <br />