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rmmmmmm <br /> gicaI TeCIM IcS 194 f Page of <br /> 1101 esty cat `� � ^ l/ Chain of Custody <br /> (209)522-4119 Fax 522-4227 <br /> E-mail geologicaltechmcs@sbeglobai net Analysis Requested Laboratory Name and Address <br /> Project# Client/Project Name <br /> 5717, c 7, M . Fqp,_e1T_ o <br /> Site Address �; c <br /> 1a `t 5' Purchase Order# <br /> 4t6Ll 66 -7 <br /> Remarks m <br /> �= X EDF Report ❑ Yes IZLNo <br /> Sampled By (print and sign name) o N Turnaround Time Standard <br /> e Woe el o 1 day, 2 day, 5 day <br /> E <br /> Date Time Sample I Dz Remarks <br /> 57-0 4 .1 a O !`11 J- 3 w x x <br /> 09 'f5 & P - <br /> 10o �4 P - � <br /> laa-a P - 3 <br /> i <br /> ReRnquis e y tura} Date Time Received 6ys�gnatuNone�s) Date Time <br /> l einqu hed by (signature) Dat Time �7 Received by (signature} g� Date Time <br /> elinquished by (s nature) Date' Time Received by (signature) Date rime <br /> Please return cooler/ice chest to Geological Technics Inc. Rev 4/2004 <br />