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GeoAnalytieal Laborat �eS, Inc. Lab Report# <br /> Regulatory A Yes ❑ No CC:XYes )VrNo ` <br /> 1405 Kansas Avenue, Suite "A" Phone (209)572-0900 Regulator: �ie ,�/ <br /> Modesto,CA 95351 Fax (209) 572-0916 <br /> Phone: (2b�) 577 <br /> Client M _ 2 CHAIN OF CUSTODY Fax: (2vq 7 ` 9/sV <br /> Address M 7C S7 � / Original To: MIKE 1< 4beje4 n/Z— <br /> City DLPc Zip <br /> Project ID OA) <br /> ( r g Lab Use Only <br /> Print Name) <br /> Sampled By Z <br /> (Signature) io ' <br /> Container w <br /> Sample type ID b <br /> ample ID z Lab # <br /> Date Time Grab Comp <br /> Matrix Type <br /> f Type Size <br /> UjW ! V49/4 2— Remarks l <br /> L3 -21aq <br /> D'SV Z �l137�a <br /> T� 1 <br /> 3 <br /> i <br /> Remarks <br /> fC C&944 <br /> Relinquished by(Signature) � Ja Time Received by nature — DTime <br /> Z CA. 7 a a <br /> Relinquished by(Signature) Date Time Received by(Signature) I Dfate Time <br /> Preservahve Mat= <br /> 0-00C ©-HCL 19-Na0H 4)-Na2S203 0-HNO3 0-112 S 04 G-Other eDrinking Water Owaste Water 4WHazardous Waste(Water) ©Soil/Solld <br /> Site Timei <br /> Start Finish 2 N Driving Time ,�Q = t7 - Time Mileage = <br /> y�M �!r Total Hours a ?i Start �1/1(/ Site Amval x2-Total vipw/NX �Q <br /> Turnaround Time ❑Standard ❑Silver Rush ❑Gold Rush ❑Platinum Rush ❑other Approved By <br />