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Z*7 <br /> GeoAnalyticaX Labors ories, Inc. Lab Report# <br /> Regulatory Mes O No CC: Yes O No , <br /> 1405 Kansas Avenue Phone: (209)572-0900 Regulator- <br /> Modesto, CA 95351 Fax- (209)572-0916 <br /> Phone: (tog ) 5-7-7— $]8b <br /> Client CHAIN OF CUSTODY Fax- (zoo } 517- 9159 <br /> Address 13EDF 13EDT Original To: <br /> City Mode5�c ::, aA Zip 9535-7 13 FIELD LOGS C.0 To: <br /> Project ID D' TOb 7 Lab Use Only <br /> (Print Name) <br /> Sampled By <br /> (S1gnatur Container u �-7 <br /> Q <br /> Sample type a Lala lD`# ` <br /> Date TimeSample ID z <br /> Grab Comp Mn'tt�tl Type Sue Remark, <br /> 11-1-eq G',0y W ' - G w 7C X `7 <br /> 10 ,Nam <br /> - G <br /> 0 Mw <br /> td� <br /> � F <br /> Remarks <br /> Relinquished by(Signature) Date Time Received tgnature) a e Ttme <br /> �� � � <br /> Relinquished by(Signature) Date Tune R the b (Signature} a e Time <br /> Preservative Matrix <br /> O4000 HCL j&Na0H4 NazSz03 0-HNO3 O-H 04 &Qher Drinlang Water 0 Waste Water 40 Hazardous Waste(Water)©Soil/Solyd <br /> Fump Truck Time Mileage <br /> Bailers 55 Gallon Drums I ff i . I <br /> Approved By: <br /> F-Zk----rAr,. ❑sww.rd ❑SINer Riah Gold Rush Platinum Rush other <br />