Laserfiche WebLink
Geol� ical7ecli� l��c® UV°le lIlAl Page—of l y <br /> 11017th Street <br /> Modesto,CA f 77 Chain of Custody <br /> (209)522-4119 Fax 522-4227 _ <br /> E-mail:gti@gmlogicaltechnics.com Analysesquested Laboratory Name and Address: <br /> Project#: ClientlProject Verne: m <br /> GA46 S(% <br /> / C�� <br /> Site Address: �' rn ' <br /> 1,60 n iP 4d d12 v a Purchase Order# <br /> GIo�QNo,�Q �lJ A/ E <br /> m 3 i= EDF Report: ❑Yes f9'No <br /> Sampled By: (print and sign n ) o T; — Turnaround Timei.s>Standard <br /> 7 o x 1 day, 2 day, 5 day <br /> Sample <br /> Date Ti Field I.D. LD. Remarks <br /> z tY' <br /> t O tv--I 5 © -n 6.' <br /> rPA tO <br /> rpt i01 w 6 <br /> ,4 <br /> Pl Ti <br /> ti 44> <br /> M e <br /> yJ <br /> d ' ✓ <br /> • <br /> I' <br /> R quished y t Date: Time: Received by: (signature) Date: Time: <br /> Relinquished b . sig ure) Date: Time: Received by:(signature) Date: Time: <br /> Relinquished by: (signature) Date: Time: Received by: (s' ature 1 Date: Ti <br /> Please return cooler/ice Chest to Geological Technics Inc. Rev.412004 <br />