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10#4a�I TQeiZ/Z�S Page of <br /> 1101 7th sneer <br /> (/0Modesto,GA Chain o$'Custody <br /> �1 <br /> 2 522-4522-4227 <br /> ( 09) 11.9 Fax _ <br /> E-maid:gti@geologicaltechnics.com Anaiys equested Laboratory Name and Address: <br /> Project#: iClienvproject lame: r <br /> G.5 Ski I 0l <br /> Silo Address: <br /> l <br /> ° o, l m <br /> Purchase O der# <br /> Global ID No: 12 <br /> .) 2f if EDF Report-. D Yes E1Clo <br /> Sampled By: (print and sign n64) o 0 3 — Turnaround Tirneil>Standard- <br /> q6l,, o X 1 day, 2 day, 6 day <br /> C3 E et <br /> Remarks <br /> Date Tlm Field I.D. Sample I.D. z � t— 'V . <br /> no-no <br /> �l <br /> R i quished y4ge) <br /> Date: Ti t Received by: (signature) Date: Time: <br /> UW' <br /> Relinquished b . Date: Time: Received by: (signature) Date: Time: <br /> Relinquished by: (signature) Date: Time: Received by: ( atur Die: Tire : i <br /> Please return cooler/ice chest to.Geological Technics Inc. Rev.,✓2004 <br />