Laserfiche WebLink
l� I_ illl■Ir <br /> GeoAnalyfical LaboratoriLab Re ort #e , JHC. <br /> : <br /> Regulatory ❑Yes Q No <br /> 1405 Kansas Avenue Phone: (209)572-0900 <br /> Modesto,CA 95351 Fax: (209)572-0916 Regulator. <br /> nn Phone: <br /> Client: ;N ��5 `i1T7A IN Of Fax: ( } 5y ? '3 mac)9 <br /> Adress: ) 'It `/ 7 No-,AV Vya � .__.._ _ CUSTODY To: C l� <br /> 5 orn curd Zip 5 3 7D <br /> Project ID r'�G o S 4 e ('� Lab Use Only <br /> Print Name) . `=�'� <br /> r� 40 , <br /> Sampled By � . <br /> (Print Name) r Container '�` ` <br /> o <br /> type * w, <br /> Sample t a .�,. T .� "� r <br /> Sample ID z ,: :. uX <br /> Date Time Grab Comp Matrix Typo Sixt Remarks ' " t <br /> . . <br /> 7171 qb ID-?S X _ l _ Ir' 0 'AICI. <br /> j1z 9 r- I L/ o X �i -Z ` l r' t k vZD f..: ,' i <br /> WAWA <br /> 'Alowl"ti Ewa <br /> 717 +--dr <br /> Remarks <br /> t <br /> Relinquished by(Signature) jV d? 7��� 9� �Ti Receiv by 'gn t re) <br /> 3 2 <br /> Relinquished by(Signature) / Date Time Received ly(S gnature) Date-I O Time <br /> Preservative: 10-4°C 0-HCI O3 -NaOH ®-Na2S203 05 -HNO3 ®-H2S O4 70-Others ®-Others <br /> Site Time: Driving Time: Total Hours <br /> Start: Finish: Total Hours: Start: Site Arrival: x2= <br /> Mileage: Approved By: <br />