Laserfiche WebLink
Geological Teckaics W. Paget of � _.- <br /> 1172 Kansas Avenue <br /> Modesto,CA Chain of Custody <br /> (209)522-4119 Fax 522-4227 <br /> E-mail: gti@gtienv.com Analysis Requested Laboratory: <br /> Project#: Client/Project Name: <br /> (D 121 C� Temp. @Shipping: Co <br /> o < <br /> Site Address: t Temp. @ Lab Receipt: co <br /> Z5 l c7 c� �.2 Purchase Order# <br /> J <br /> fZi.tcss' S - � gGt <br /> Global ID No.: T �f <br /> 6 p EDF Report: <br /> LJ Yes A No <br /> t o o N <br /> �� J Turnaround Tim _ Standar <br /> Sampled By: (print and sign name) <br /> L �J 1 day 2 day 5 day <br /> E�c..r:c� �t�;vv� _ r•-- o w <br /> Date Time Fiel D' Sample I.D. z t 1i� Remarks <br /> 1,51111 Sjz i S t1� <br /> 3zv a <br /> C-'X"C)ii 1 <br /> 3 s - <br /> tv <br /> � � q ESI©l7 l <br /> Relinquished by: ( ig� Date: Time: R ei ed by: (signature) /, Date- Time: <br /> Zi if I y 1 P lit <br /> Ref quis ed by: (signature) Date: Time: Fie eived by: (signature) Date: Time: <br /> Relinquished by: (signature) Date: Time: Received by: (signature) Date: Time: <br /> Please return cooler/ice chest to Geological Technics Inc. Rev.2/2009 <br />