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age <br /> 7echda Inc. <br /> 11017th Street ��� � oc� <br /> Modesto,CA Chain of Custody <br /> (209)522-4119 Fax 522-4227 <br /> E-mail geologicaltechmes@sbcglobal net Analysis Requested Laboratory Name and Address <br /> Project# Client/Project Name <br /> 507+ T. M E Ui p .-=# O <br /> Site Address Vi r­w <br /> co\ f 5 Purchase Order# <br /> Remarks4 4+16 E <br /> ' EDF Report ❑ Yes 9 No <br /> Sampled 8y (pnnt and sign name) v � o � Turnaround Time S <br /> Standard <br /> L, OC)a / 1 day,2 day, 5 day <br /> Date Time sample l D z Ca Remarks <br /> 7-S-01 0'2a \ - 9 3 UI S k i <br /> Ff <br /> inquis d b ignature) Date , Time Received by (signature) Date Time <br /> nquish d by (signature) Date Time Deceived by (signatur Dae Time f fr 6 f�ti' rti c() r- !�1 "-,,T L r�YC � i r' <br /> I(elinquished by (si6nature) Date Time Received by (signature) Date Time <br /> Please return cooler/ice chest to Geological Technics Inc. Rev 4=04 <br />