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CAZ <br /> Lab Report# <br /> �-- GeoAnal tical Laboratories, Inc. <br />- � Regulatory Yes ❑ No �¢-�"f'J'• <br /> 1405 Kansas Avenue Phone: (209 572-0900 L"A) Regulator: � ' u ^d <br /> Modesto,CA 95351 Fax: (209) 572-0916 <br /> Phone: (zef 3 O S <br /> Client: W R IC2h(T 4ffNV/92r7Vrt 1CA1+4L __ CHAIN OF CUSTODY Fax: <br /> Address: [o 7 dP . 107`A SJ�- _ To: � <br /> City 6W• zip. 953 7k <br /> Project ID 49CO C n/ � /03CXZ0AJ ,¢ Lab Use Only <br /> (Print Name) <br /> Sampled By a °� <br /> (signature) Container k ,� <br /> 0 <br /> Sample type �, Lab ID# . <br /> Date Time Grab Comp Matrix ;. Sample 1D Type size Q ¢" <br /> � zK6 lRemarks IJ ZZ I <br /> -9- 5-9 P <br /> zo s 2 /3/z I X X . r <br /> 3Z3 S v X Xz <br /> 3I KS <br /> Z Sye z2'! XIZZ7 ! <br /> zZq v r <br /> . � sP s-� zzySsl <br /> z r <br /> SP 5�' G /. u j �f 3 r <br /> R ks yy3 <br /> sP� <br /> Zu <br /> f, y. Rs ,gyp <br /> .SP <br /> inquishcd by(Signature) w /Z—Sat 9$/ i eceiv by(Sin ure} \j <br /> to Time S <br /> yr <br /> Relinquished by(Signature) Date Time Re eived by(Signature) D e Time <br />'E "Preservative: ID-4°C ©-HCI Q-Na0H ®-Na,SZ03 (D-HNO3 (0-HS 04 Q-Other ®-Other <br /> Time: Total Hours <br /> Driving <br /> site•time: / f✓,z <br /> $fait: %5 Finish: S y� Total Hours: �/� Slam' '�� Site Arrival: x2= z 5 <br /> Mileage: — Approved By: <br /> r <br />