Laserfiche WebLink
Ge®A nalytical Laboratories, Inc. <br /> 1031 Kansas Ave., Suite C <br /> • Modesto, California 95351 Phone (209) 573-0900 <br /> . Fax x((209) 572-0916 <br /> CHAIN OF CUSTODY i i :? <br /> Cliont .N1 <br /> 11 <br /> Address Phone_ <br /> � 1 l -•R-�q"•- � <br /> CC to: <br /> r--• <br /> zip <br /> ' 1 <br /> r�0 <br /> PROJECT ID-, 4 <br /> DSA�ft�'LED✓41-S.�1an1t�eI'U�I. c,v\ i C-- _— A <br /> � <br /> BY:(signature) v <br /> J� <br /> .^con- <br /> REMARKS <br /> type <br /> ate Tme <br /> Sample Location <br /> . 7 � •Src v <br /> •�-�� it:�� �~J ';� ,C � � X r � �1{�^ O � <br /> Ile <br /> elinEJui b s, - Date Time Received by(signature): <br /> Date Time <br /> .7„0. �•l)� <br /> Retinquishsd by(signature): <br /> Date Time Received by(signature): <br /> Date Time <br /> Relinquished by(signature): Date Time Received h <br /> „ y(signature): Date rime <br /> Rellnqulshed oy(signature): Date Time Received by{signature}: <br /> Date Time <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Site Time: <br /> ° Start: Finish: Total HDriving Time: <br /> Hours: S 4 <br /> � tart: 1 Finish: �2•�S�Total Hours: <br /> Garan Graprtca r2M•527Ji57 - �� i�. . - ��� , <br />