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Lab Report# i:• <br /> 1�-- ---.� GeoAnalytical Laboratories, Inc. <br /> Regulatory ❑Yes 0 No <br /> 1405 Kansas Avenue Phone: (209) 572-0900 Regulator: <br /> Modesto, CA 95351 lax: (209) 572-0916 <br /> I Phone: ( ) <br /> W07 f J�� N <br /> Client: FiV/ f CHAIN OF CUSTODY Fax: { } <br /> � <br /> To: <br /> Address: <br /> , <br /> 14 <br /> City LZip <br /> Prctjec( 1n Lab Use Only ;. <br /> 4 a <br /> (f 'int N:nnc) _Q© A ,�,� � a � <br /> Sampled By CGt o V <br /> (Signature) Container � �`< � � > <br /> o �. <br /> Sample type <br /> Sample 11) � �� � Lab ID# a <br /> Date Time (4i dr Comp Matrix "lypc Size <br /> iz Z s <br /> c7Z= r <br /> ltctnarks . <br /> D't' Timc lteceivet uy( i nature) Dale Time <br /> Rclinquisbed b ( •n; ne) r ' <br /> Rclinyuished by(Signal' Date Tion: Ice Ved )y(Signature) Dare Tirtte <br /> i <br /> Preservative: &411C 0-HCI -Na01-I Q-Na2S203 5 -HNO3 &H2S O4 70-Other ®-Other <br /> Srrc'I'nuc: Dtiving Tintc: Total l(ours <br /> Srait: Finish: Tural I tun's: Star Sir Arrival: x2= <br /> Mileage: _ _ Approved I3y: _ � <br />