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c7eo kat Technics inc. Page—of- <br /> 1101 <br /> ageof1101 7th Street <br /> Modesto,CA Cham of Custody ' <br /> (209)522-4119 Fax 522-4227 <br /> E-mail geologicaltechnres@sbcglobal net Analysis Requested Laboratory Name and Address <br /> Project# Ciient/Prolect game <br /> S0�f°Z o G� S <br /> Site Address <br /> 2 Iu C H+��Y� � 5� /7Wc� Purchase Order# <br /> Remarks v V 4 <br /> V 3-1�L�Z- -T <br /> talc 6t rrJ� t"Ov--* AM-10 4/n.l EDF Report Q Ye�k 3440 <br /> Sam led By (punt and sign name) o a ° Turnaround Time =Standard <br /> o Cw ! day, 2 day, 5 day <br /> ate Time Sample I Q z F �- V Remarks <br /> 04 1N-3o Got - C0 r—, zfiir(�' 0 <br /> 04 C 2- t.1 13 5 <br /> 13 j �s G[,cVcS vjbt w <br /> �irl� <br /> Relinquished by (signAturej AtTime Received by (signature) Date Time <br /> 9j6V l b 3io <br /> R squished by (nature) Date Time Received by (signature) Rate Time <br /> Relinquished by (signature) Date Time ReceiveW( t } DateTime <br /> -�fllOC� 1035 <br /> Please return coolerlice chest to Geological Technics Inc. Rev 12,03 <br />