Laserfiche WebLink
ort# <br /> .— � GeoAnal tical Laboratkes, Inc. Lab Reg <br /> y Regulatory ❑Yes ❑ No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 Regulator: <br /> Modesto, CA 95351 Fax: (209) 572-0916_ <br /> Phone: (Qpt} <br /> Client: J �ab tr c>( CHAIN OF CUSTODY Fax: (2o4r? ar <br /> Address: <br /> To: <br /> City Zip 5a <br /> Project IDj �4Lab Use Only <br /> (Print N <br /> Sampled By <br /> k <br /> (SkgZlor Container <br /> C6 Lab YD# d <br /> Sample typ <br /> e <br /> Date Time Sample ID Type Size a' <br /> Grab Comp Matrix <br /> Remarks � <br /> �{ t f 3i <br /> Remarks ! T <br /> infshed�yi( ignat c) Date Time Ite�ei Dille Time— <br /> Rehttq s VU by ISign R,urc f Dale Timeceived by(Signature) Date Time <br /> Preservative: 1Q-4°C 02 -HCI Q-NalDH &Na2S203 QQ -HNO3 ®-H,$/ 4 (D-Other ®-Other <br /> Site Time: Driving Time: Total Hours <br /> Stan: Finish: Total Hours: Start. Site Arrival: x2= <br /> Mileage: Approved By: <br /> , i <br />