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eoyticl Laboratories, Inc. <br />1405 Kansas Ave., Suite A <br />Modesto. CA 95351 <br />Client o 1 Late 01 <br />Address <br />CHAIN OF CUSTODY <br />Zip <br />w <br />Phone (209) 572-0900 <br />Fax #(209) 572-0916 1z <br />ZM <br />16980 <br />Phone (� p A 4 �1 t <br />CC 40: <br />k,, LaA 1 y l C ~ <br />Jt' ^.�o(wwu � C.C. <br />P) I QV I�Kn�� <br />PROJECT ID <br />nc� C t'14 M ^t <br />No. <br />of <br />ANALYSIS <br />// <br />REMARKS <br />SAMPL D BY•n ur)QL <br />con <br />tain- <br />ers <br />Date Time bpee Sample ID <br />Grab Comp. <br />X k k X x x <br />Met- s <br />J, <br />X <br />x >G X x x <br />2\ <br />o <br />• <br />,� <br />.3<f x- x x <br />GR <br />1!222a <br />3css` <br />t <br />xxx x <br />xI <br />X X. 'X X k <br />oL <br />! 0 3 <br />Relinquig ure <br />5w— <br />a <br />Time <br />Received by (signature): <br />Date <br />f 9 <br />Time <br />�f %3S <br />Relinquished by.(signature): <br />Date <br />Time <br />Receiv by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Site Time:Driving <br />Start: Finish: a.,. <br />Total Hours: 445,441� <br />Time: <br />Start: Finish: <br />Total Hours: <br />Mileage ��y Approved By <br />Garoli Graphics (209) 527.3667 <br />w - <br />