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i <br /> �� • LaMill <br /> b Report# ----- <br /> Inc. <br /> GeoAnalytleal LaboraL.,- :.es <br /> ._� Regulatory El Yes ❑ No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 Regulator: f <br /> Modesto,CA 95351 Fax: (209) 572-0916 <br /> Plione: ( ) <br /> Client: C_ CHAIN OF CUSTODY rax: ( ) <br /> To: <br /> Address: <br /> City Zip <br /> ��� Lab Use Only <br /> Project ID )cd )n�` j' d �� <br /> (Print N me) c y� 4 > <br /> Sampled By _ <br /> (Signata ) Container _ <br /> ° Lab ID# w <br /> Sa ple type :c' V� 0, <br /> Sample ID Type Size <br /> Date Time Drab Cornp Matrix <br /> �) � ��� Remarks <br /> 2 <br /> Xly <br /> e,-, o' x �- <br /> � � Sr� <br /> - Lfe A- kL-70qHCf <br /> 3 ; W <br /> 2 d5 x <br /> Remarks <br /> [)ate Time RecW(Sifure) <br /> ate TjReEioquished y(Signa[ Date Time eceived Date yimc <br /> Relin " d by(Signature) <br /> I <br /> Pre ®-4°C Q-HCI O-NaOH ®-NaZS2O, 05 -HNO3 ®-H2 O, 7O-Other ®-Other <br /> Driving Time: Total Yours <br /> Site Time: Stan: <br /> Site Arrival: x2= <br /> Slant: Finish: Total)lours: <br /> Mileage: Approved By: <br />