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GeoAnalytical Laboratories , Inc . LabIRegulatory Yes <br /> ory Yes O No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 S'�J � � e� ��5 �t„ <br /> Modesto, CA 95351 Fax: (209) 572-0916 Regulator : �$ ri <br /> Phone : (ZD9 ) > <; 17r <br /> Client: i A140U,E� Cr*) id CHAIN OF CUSTODY Fax: C41 4� 6 � ' <br /> Address: 3S/ Al - J9,ecKui(- AJ To : <br /> City � r�` Com • Zip 95'2, ZU � <br /> Project ID QA .jb POOL Ci4 Lab Use Only <br /> (Print Name) <br /> U <br /> Sampled By a <br /> (Af <br /> U Y <br /> (Signature) Container �Q' <br /> a <br /> 47 <br /> o Q <br /> Sample typeGrab Comp Matrix z° !� Lab ID # <br /> Date Time ample ID tyke Size a <br /> L <br /> O,(( <br /> oz rix 1. 5 b'a l <br /> !/ o14, U415t?5 <br /> de�; 141 ><7 >0 U a/S 8 <br /> / e ! / L ' <br /> l5r <br /> � z3V X C6 e �LT159a l <br /> z3X1X I � rs93 / <br /> Remarks or <br /> Relinquished y i alurn) ga"te Tii -itterve (signature) Date Tim <br /> Relinquished by Si m •) Date Tine Received by (Signature) Date Tim <br /> Preservative : 1&4°C ©-HCI Q-NaOH ®-NaA03 D -HNO3 ©-H2SO4 07 -Other &Ofher <br /> Site Time: T i / ( Driving � /Z _ Total Hours <br /> Stan: (�(./ Finis Total Hours: Std' SR x2= <br /> c/ �,tc /z <br /> Mileage: �7_ z ' r0 7 { i5 Approved By: <br />