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-- ANALYTICAL REQUEST I SAMPt CHAIN OF CUSTODY -- LAB.TRACKING I` <br /> RECORD J OF 1 DATE RECIEVED: <br /> LAB.INVOICE TO: .--=?`•t�l_C���X1..x_�`�/ ��-.1-1-1 <br /> DEL—TECH GEOTECHNICAL SUPPORT SERVICES <br /> 10624 OLIVE AVENUE,OAKDALE,CA.95361 ----------------------- <br /> OFFICE-(209)847-8757 PIi.# _— ��yCONTACT: — <br /> FAX -(209)847-7744 <br /> CALIFORNIA CONTRACTORS LICENSE#657366/CLASS"A"ENGINEERING _ INVOICE#------- P.O.# <br /> LAB.ANALYSIS REQUESTED SUE SAMPLING MAP <br /> CLIENT: CONSULTANT: v m <br /> E- oc <br /> SITE NAME: PROJECT: I R-- o • �: <br /> awrt x � k <br /> ADDRESS: CITY: ST.: z re O m <br /> Wr <br /> SAMPLER SIGNATURE: TtAA) <br /> WAYBILL#: U G 00 g O ac 000 < <br /> SHIPPED VIA: H <br /> ANALYSIS BY: TURNAROUND TIME: DAYS o w '� ) <br /> SAMPLE I.D.0 DATE TIME CONTAINERS TYPE MATRIX REMARKS/LAB. I.D. <br /> Ia —3 3 <br /> 2.) _ 3 c 0 -1 ESe C- a L �s <br /> -) — Z D A <br /> S.) <br /> 6.) -' <br /> 7.) <br /> e.) �ticv-- -13 <br /> ID.) „— bz <br /> I.) 113v <br /> Z.) r^AAJ _ enT 7v Cc 2h 5 <br /> 3. <br /> I4.) <br /> I s.) _ <br /> ISIuD BY: <br /> A RBCEVED BY: I AI`� SAMPLE INT GRI /CONDITION <br /> n (SMATUREI 3D RECEIVED COLD A INTACT / YES k'-', NO ! J <br /> REIMQUIS3UD B5': A/ / RECEIVED BY: E AIR BUBBLES IN V.O.A.'S / YES ( NO{� UNP/S I- <br /> .� O QO (SpNANR� ( J` -I /�-�- �1'UQ CUSTODY SEALS INTACT / YES NO ! 1 N/A t i <br /> A / DATE I TME <br /> RFI.OIQUISF(FD B\': <br /> RRMIvPDBY: PRESERVATfVESUSED / YEs NO ( <br /> / (SK NAMnW) V <br /> NOTE: PLEASE ARCHIVE THE SAMPLES SUBMITTED FOR THE PULL HOLDING TIME ALLOWED,UNLESS OTHER ARRANGEMENTS ARE MADE. * (M.T.B.E.,T.A.M.E.,E.T.B.E_D.Ip.E_TB-A.) <br /> B.B.=BAILER BLANKS COLLECTED IN THE FIELD. F.B.-FIELD BLANKS COLLECTED IN THE IMLI). <br /> PINK-FIELD COP)' WHITE h YELLOW-TO LAB.WITH SAMPLES VFLLOW-RETURN TO CLIENT WITH RESULTS DEL�TECH C.O.C.FORM ri <br />