Laserfiche WebLink
6 SAMPLE CHAIN OILUSTODY RECORD <br /> DEL-TECH GEOTECHNICAL SUPPORT (PLEASE PRINT) Lab. Analysis by <br /> LAB INVOICE TO <br /> 10624 OLIVE AVE. OAKDALE, CALIFORNIA 95361 B P <br /> OFFICE (209) 847-8757 PH.# <br /> FAX (209) 847-7744 RECORD __LO <br /> PO.#/INVOICE# <br /> CLIENT / CONSULTANT: <br /> ANALYSIS REQUESTED SITE SAMPLE MAP <br /> QEo'T rosceW t"} <br /> (ITEMIZED AND CHECKED BELOW)TF <br /> 1.7��/ (NORTH <br /> PROJECT 1 SITE NAME <br /> _ M cr <br /> Z !r <br /> v _ Qpm U Q <br /> { 2 I1C4 Q <br /> STREET ! > ' T( ` 4 ITT 1 � STATE ?o M o W <br /> o ,n LU <br /> O� Ocn <br /> m o w} LU W <br /> s� HTP VIA [ 1 � L w ac x LU m <br /> SAM '`° 1�s[cNATL>Ri AYBILL# lOG` `� l4- S_ i" M a <br /> Q v C:) w z CL <br /> w <br /> NUMBER TYPE ,AMPLE CD o �w x o o ca <br /> SAMPLE LOCATION DATE TIME vF (GRAB DRTRIX a a F-ca m REMARKS I SPECIAL INSTRUCTIONS BELOW <br /> MA{IDENTIFICATION) MTHlDAI11B. HOUR I MIN CONTAINERS COMPOSITE) <br /> 2) � <br /> 6) Y'ww- 1- ' <br /> 7) 'P R M O <br /> S) <br /> 9) <br /> IO) r i 1 SAMPLE INTEGRTT I/CONDITION A TURNAR <br /> s i <br /> RECEIVED COW d INTACT ! t ES 17, <br /> �� � I' PRESERVATIVES USED�. ,}ES � <br /> ATE1T[hSE' YEDBt srcwrnci ATE7TIME <br /> RELI QU HED BY cs xa ■n CUSTOM SEALS INTACT 1 tES ( NU <br /> i� AIR RUBBLUS IN 4 OA S 1 YES 1 A() � <br /> ATEI TIMI, E Eft ED B} rsrrvr.Tti%ci ATI:!TIMP. <br /> INQU[SHED B} EirrM T—MEG TURN AROUND TIFfE CIIECA UNF <br /> T r /��T/�p 7.1 HOUR 48 HOUR UA} <br /> RELINQLESHFA 81 <br /> ATEI TIht[ FCE1VhD H}�j_4U0RAT0RI' wTE TI RM1�%P��TINfv ATP/TIMF <br /> NOTE LA$ORATdRY SAMPLE ARCHIVING WILL BE 30 DAPS FROM THE HATE SAMPLE WAS COLLECTED,UNLESS OTHER ARRAINGEMEN'TS ARE MAD& DEL-TECH FORM C O C <br /> PLEASE RERN DEL-TECH'S ICE CHEST AND BLUE ICE AS SOON AS POSSIBLE THANK YOU <br /> TU <br /> Pink - Field Copy / White & Yellow - To Laboratory with Samples 1 Yellow - Return to Client with Results <br />