Laserfiche WebLink
1 <br /> warm.— GeoAnalytical Laboratories, Inc.Ip l.�b It:pert a <br /> Regulatory ❑Yes D No <br /> 1405 Kansas Avenue Phone- (209)572-0900 <br /> Modesto,CA 95351 Fax: (209)572-0916 <br /> Regulator: <br /> Client; 1�r' E�d'ro t CHAIN OF CUSTODY Farr: ( } <br /> To: <br /> Address. <br /> City Zip <br /> IPo'ect IOb <br /> Lab Use Only <br /> (Print Nurse) _Ta+ �►� k ^• <br /> Sampled By <br /> (SipUute) Container <br /> i Sample type �Q L tr Lab IU <br /> Sample Ill /'t <br /> } Daie Time Trp. sr,e •, la. <br /> c� <br /> Q ! 1l'Q '� c .w [5?Y9 Z30 ✓ ` r <br /> ..� cD <br /> 1 i FTh T+ <br /> i <br /> ' lkr 1 ' r 9 rr■ee T'Lme l<eoesred 6y{s;g.ie■n1 [>a+c rme <br /> 15 <br /> `fU 3:j <br /> D 1Lel. led�/e�+s*+n•e� a.x Time it"Ved by(Sitmewe) f rime <br /> Preservative: ©-4°C O-HCl Q-NaON }-NaaS,C}, -HN©, la-H2S Oe Q-Other -Oif�er <br /> Dririac Tim: Toed lion <br /> ` m �«■r�.e: Slat: <br /> Stitt: Mask Teal lbws: Sile Mtrivwl: ■7. <br /> i <br /> } _ Mika*e: <br /> Approved By: -20 !2 <br />