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aaQCI'LiZL Inc. Page _of <br /> I ,r�444 <br /> g <br /> 1101 7th Street <br /> Modesto,CA (�f� Chain of Custody <br /> ''"' <br /> (209)522-41.19 Fax 522-4227 <br /> E-mail.geologicaltechmcs@sbcglobal net Analysis Requested Laboratory Name and Address <br /> Project# Client/Project Name <br /> Site Address C <br /> w �,4, ,yj is Purchase Order# <br /> Remarks " v 13 a -T <br /> 16 E <br /> �: i= \ EDF Report EI-Yes a No <br /> Sampled By (print and sign name) o 0 Turnaround Time S=Standard <br /> n { la ( m 1 day, 2 day, 5 day <br /> ate Time Sam le I D � `� � <br /> p Remarks <br /> CW2—lilr <br /> o 1 <br /> Relpcluished by tuxg} Date Time Received by (signature) Date Time <br /> RVr1 uighed by (signa#i(re) Date Time Fleceived by (signature') Date Time <br /> 1'- _4 <br /> Ffelinquished by (signature) Datd Time Received by signature) Date Tune <br /> Please return cooler/ice chest to Geological Technics Inc. Rev 17/03 <br />