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GeoAnalytical Laboratories, Inc. Lab Report# T 7 D LZ 0 <br /> Regulatory Mes ©No CC: C1 Yes D No <br /> 1405 Kansas Avenue Phone: (209)572-0900 Toua Yang <br /> Modesto,CA 95351 Fax: (209) 572-0916 <br /> Regulator: 9 <br /> Phone: (209 ) 468-3459 <br /> Client: Jim Thorpe, Inc. CHAIN OF CUSTODY Fax: { 209 ) 466-3433 <br /> Address: P 0 Box 357 13 EDF C7 EDT Original To: <br /> City Lodi, CA Zip 95241-0357 13 FIELD LOGS C.0 To: San Joaquin Co EHD <br /> Project ID Patel - Delta Hotel Lab Use Only <br /> (Print Name) ca, <br /> Sampled By Keith Berri ger y <br /> (Signature) Container a <br /> o � � <br /> Sample type Lab ID# <br /> Sample ID z ui <br /> r Date Time Grab Comp Matrix �'� Srzc �- m <br /> Relinqui by ig 1 Pate_ n Ti me Recc b� 5ignuu Date Time <br /> 7 tr <br /> 1230 � 17l07 J <br /> Relinquished b (Signature) Date Time Received by(Signature) Date Tirrx <br /> Pea ervative: matrix <br /> 0 4Q*HC1_�OHNa1SZO,0-11140, O-H Oa 0-Mer_ Drinking Water®Waste Water =1 Hazardous Waste(Water)*Soil/5olid <br /> ,. <br /> Pump'truck Tlme Mileage <br /> Batters 55 Gallon Drums <br /> Approved By: .t <br /> '' 7trrward 71se13suwawd l3syff Rash Cold Rm0 cipwimmiush OMsr 4 <br />