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IPA' FMI <br /> _- GeoAnalytical Laboratories, Inc. Lab Report# � - b <br /> Regulatory es ONo CC: es 13 No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 //�� � " �[er.0 co <br /> Modesto,CA 95351 Fax: (209) 572-0916 Regulator: 5s�✓'ati3ya <br /> Phone: <br /> Client: �tjZe2-Qf pper�t/( CHAIN OF CUSTODY Fax: <br /> Address: Y�C� bC yC 55-1— 13EDF 13 EDT Original To: 6"- <br /> GT & .�'l/!&u <br /> City LG Cast. Zip CiYS�Y� 0 FIELD LOGS C.0 To: JO/tnl 'j ACKSon l <br /> Project ID 76 7 AJ . /4 P/ — Sim cKi/ati l a 0 ua`�11 , <br /> Lab Use Only <br /> (Print Name) 7 �}/ e G~ y v <br /> 1 Sampled By e" - C ~ �I i± <br /> l (Signature) I Q w <br /> C <br /> e <br /> Container v <br /> Sample typeo y�� Lab ID# <br /> Date Time Grab Comp Matrix Sample ID Type size z �� /� <br /> 6 f X X Remarks Pew 171 ij <br /> 1 c < eer, x 0 (01 1 <br /> Remarks <br /> Relinquished by(Signalure) Daze Time Received i ature) ale Time <br /> Relinquished by(Signature) Date Time Received by(Si gnatum) Date Tice <br /> PrW <br /> Na2 &Other Water Waste Water Matrix <br /> O40�HCL N NaS'23© 3O- 4 9 ® ® Hazardous Waste(Water) <br /> Soil/Solid <br /> Pump Truck Time /jam. Mileage J ' <br /> Bailers 55 Gallon Drums r <br /> m.....w.a n... ❑st..aw Rh..r Rwh 171GaaR.h R.a. .R.h om.. Approved By: � <br />