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GeoAnalytical Laboratories, Inc. <br /> Lab Report# <br /> Regulatory 13Yes ONo CC: DYes 13 No c <br /> 1405 Kansas Avenue Phone: (209)572-0900 Regulator: ;7� <br /> Modesto, CA 95351 Fax: (209) 572-09 16 <br /> Phone: <br /> Client: TYl QCT O �1 CHAIN OF CUSTODY Fax: ( ) 3(f'F�— j ^ Imp <br /> Address: 'P C ) 1*4,C)X 35-7 13EDF 13EDT Original To: <br /> City L r C)d 1 i CA Zipq 5:.2 LA 0 FIELD LOGS CX To: <br /> Project ID <br /> Lab Use Only <br /> 2 L � 5 <br /> (PrintN�lme) W ��~ <br /> Sampled By t Qy <br /> (Signator Container <br /> Sam type z° Lab ID# <br /> Date Time Sample ID type size — 44 <br /> Grab Comp Matri, Remar i <br /> O li �Z <br /> d' <br /> o I/ 1 10 0 61,9 <br /> i <br /> Remarks <br /> e uis ed y 'igna[ure) Dale '�i Receive y(Sig ature) / Da Time <br /> 53 �� <br /> Relinquished v(Signature) Dale Time ecei a by(Signature) Date Time <br /> Pre ervative: Matrix r <br /> O4°C8 HCL&NaOH NaZS203© HNO3 O H S Oa 0Other�Drinking Water®Waste Water ® Hazardous Wash(Water)©SoiUSolid <br /> Pump Truck Time Mileag <br /> Bailers 55 Gallon Drums— E3 <br /> Approved By: <br /> lLrnvmuml lime o$ImMOrd ❑Saver RusM1 Gold RusM1 %vlinum RurM1 Other <br />