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SAM E CHAIN <br /> drCUTWIM ffCD <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab. Analysis by <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 LAB. INVOICE TO <br /> OFFICE (209)847-8757 ' <br /> FAX (209) 847-7744 RECORD _j _OF -2- PH.# <br /> CLIENT / CONSULTANT: 4haEFE14 ALES 'b- P.O.# INVOICE# <br /> 0&L*cx_TmC1 n �,�,� ANALYSIS REQUESTED SITE SAMPLE MAP <br /> PROJECT 1 SITE NAME U I I (ITEMl7ED AND CHECAED BELOW) '"°T' PL �� <br /> co <br /> (NORTH <br /> STREET t •� � c� CITY abwoll STATE A' � c '� � � <br /> 1 �� HIP VW ��� 8 Lu <br /> Lu s a m <br /> SAMPL (PltnaTED SIGNA <br /> WAYBILL# o Lu <br /> r1 I z�" L - <br /> o ¢ a w i■rV <br /> SAMPLE LOCATION DATE TIME NUMBED 7YPE SAMPLE ca a z tZ x o o d s <br /> OF <br /> (cRAO ox MATRIX a a o N N pJ x <br /> (IDENTIFICATION) MTHJDAYI}7L. AOUR/MIN mNTAIXERS COMPOSITE) I.M "- m m m m KEMARKS/ SPECIA.L INSTRUCTIONS EEIAw <br /> z) � <br /> 3) <br /> 4) <br /> 6) !— <br /> g? 6- <br /> 9) «. <br /> �� //�'� �l ��„ /�� �r 'J J�/���/ ►*SAMPLE INTEGRrTl!CONDITION 6 TURNAROUND TIME ++ <br /> RECEIVED COLD k INTACT ! YES �'j NO �( } <br /> kNI�Stl::D BYTv-, ATE/TIME 1116EIIED ON mcmme=, DATVTIE?�' <br /> PRESERVATIVES USED � ES V NO <br /> CUSTODY SEALS INTACT I YES NO { �y NA�/) <br /> AIR BUBBLES IN"v OA'S I YES NO /I LINE k <br /> RELINQUISHED ON OWMT E, ATE!TIME RECEINED ON pmKAT c, ATE!TIME Y <br /> TURN AROUND TIME CHECAONE <br /> RELiNQL1SIIFD B1 QN"TME. DATE TtMRECEIVED R}'L.ABORATORI' .NUT[rLP +NatINMDTIMI, ATF!TIME [21 HOUR } 4S HOUR DAI 10 DA) <br /> ROTE LABORATORY SAMPLE ARCHIVING WILL BE 30 DAYS FROM THE DATE SAN'IPLE WAS COLLECTED,UNLESS OTHER ARRAINGE'MEN"I'S ARE MAD& <br /> PLEASE RETURN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE THANK YOU DEL-TECH FORM C O C <br /> Pink`- Field Copy 1 White & Yellow - To Laboratory with Samples / Yellow - Return to Client with Results <br />