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GeoAnalytical Laboratories, Inc. Lab Report# <br /> as Regulatory 0,Yes t] No CC:OXes ❑ No <br /> 1405 Kansas Avenue, Suite "A" Phone: (209)572-0900 Regulator: <br /> Modesto,CA 95351 Fax: (209)572-0916 <br /> / Phone: ( ) <br /> Client: Th[w�P (i I L CHAIN OF CUSTODY Fax: ( ) <br /> Address: Original To: <br /> City Zip Reporting: ❑EDF O EDT <br /> Project ID 2 a ; rn rn Lab Use Only <br /> (Print Name) <br /> Sampled By scu✓ rch e z 4 <br /> (Signature) C y Container <br /> ar <br /> Sample type Sample ID z' 1L O Lab ID# <br /> Date Time Gmb Com Mamx L p type Sin Ow <br /> 03 S 4t(—' 2 s I I I 1 11 tl I Remarks!Qwtetl <br /> � I <br /> \ p <br /> I C� <br /> I <br /> ( <br /> Remarks <br /> Relinquished by(Signature) D719 99 41 Al <br /> Tim R iv eQ i Dat - Ti <br /> Relinquished by(Signature) Date Time eceived by azure) - Da rime <br /> Preservative Matrix <br /> 0-4eC ®-HCL @-NaOH Q-Na3S203 Q-HNO3 Q-H2 S O4 Q-Other 4ODrinking Water toWaste Water®Hazardou Waste(Water) ©Soil/Solid <br /> Site Time: Privfng•lime: - ^ a Mileage <br /> Finish: .' 'Toml Hours: Start: 12- S +� Site Arrival; z:L S,.�x2=Total: 1 M = S <br /> i <br /> �15me tandard pSilvor Ruah OGold Rush OPlatinum Rush pOtherf - A roved By <br />