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lk <br /> -- - eoAnal tical Laboratories Inc. Lab Report# 1 <br /> y � Regulatory Cl Yes ❑ No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 <br /> Modesto,CA 95351 Fax: (209) 572-0916 Regulator: <br /> Phone: ( ) <br /> Client: AM l/t'AAI GEaGoGicgL_ S2vi 6E s 1AIc. CHAIN OF CUSTODY rax: ( ) <br /> Address: 1989 7 114"Vi 1"'14 y To: <br /> City 5-eN01� zip 9s 3 ?o <br /> Project ID 4 /44-tJ�L_ Oq Stz-VA � rr Lab Use Only <br /> (Print Name) <br /> p <br /> Sam led Byca <br /> (Signature) Container <br /> I <br /> Sample type Lab ID# a <br /> Date i55i2_ <br /> jo, <br /> �p Sample ID .tyke size A, <br /> Grab Comp Matrix 17 <br /> Point <br /> U ' <br /> Zry1�9 M0 S —� tnl 0,4,Ry PuNnc ��M 1 Remark <br /> tl _ CLW ✓r I <br /> 1 <br /> f <br /> t <br /> Remarks <br /> Relinquished by(SignaDate Time I c i e m nn ' e Tine <br /> l � l 9 � 3 9 � +�� , �LJTi <br /> 1 <br /> Relinquished by(Signature) Date Iintc eccived by(Sign tire) Date Time <br /> Preservative: 1Q-4°C 02 -HCI 3O-NaOH40-Na2S203 05 -HNO3 @-H 2S 4 D-Other ®-Other <br /> Site Tinte: Driving Time: Total Hours <br /> Start: Finish: Total Hours: Stan: Site Arrival: x2= <br /> Mileage: Approved I3y: <br />