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c7co6giat rechft X' s Ific. 'Page of <br /> 11017th Street <br /> Modesto,CA Chain Of CUStody <br /> (209)522-4119 Fax 522-4227 6 <br /> E-nmil: Analysis Requested <br /> Laboratory Name and Address: <br /> Project Client/Project Name: <br /> <D <br /> Site Address: <br /> cc <br /> Purchase Order# <br /> Global ID No.: <br /> L <br /> E <br /> EDF Report: 0 Yes <br /> Samplp(i int and sign name) 0 <br /> rime.-- <br /> 0 Turnaround Time: �F- <br /> 0 n 4ed <br /> -,5 x 1 day, 2 day, 5 day <br /> Date E <br /> Time Field I.D. Sample LD. 6 <br /> z Remarks <br /> C <br /> 17, <br /> C <br /> 71'- <br /> -(CIS <br /> Re4p9uished-bly: (signature) Date: Time: Re eived�Y: {signature} <br /> "o C <br /> bat <br /> Time: <br /> Rellitushed by: (signature) Date: Time: MTime <br /> Aec� d by:4(fsi'n ure) <br /> D Time: <br /> T <br /> Rl nqu-isfied by: (signature) <br /> Date: Time: Received by: ig store) <br /> D Time: <br /> Please return cooler/ice chest to Geological Technics Inc. <br /> Rev.4/2004 <br />