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'l <br /> I int 7th rvtr44t <br /> Modesto.Dai Chain of Custody <br /> 12091 522-4114 Fax S22-4227 <br /> E-r1Wi�: Keu]crkiealtuchmcti4�¢h�glo-bal]tet Analysis R <br /> ly equr's#ed Laboratory Name and Address' <br /> Pro ect#: Clien:P-a*t Name: l J�� <br /> ' � G �SCrlfPriJ 11}1 <br /> Site A^�ddress: <br /> J J <br /> f &'5 �(p <br /> Remarks Lab Purchase Order <br /> r <br /> Sam�pl�d By: (prl anri sign narn£+' n Tumaraund Time: $tarxiard :1 ASAP <br /> }- 2a Hour U fattier — <br /> s 1 <br /> Date Time Semple i.D. z 2 Remarks <br /> A <br /> GUMUY SEAL INTACT? <br /> Y K TEMP <br /> Re.irCuighed by: (ea.7att:rgh;, p e; Time; Received by:{sifiaature; Dale: Time: <br /> J <br /> Relincuished b} : (siannture) [?a'p: Time- Received by-{sic nature; pate: Time: <br /> Be irgtistiea by, (signature► Date: Tuna: Recgived rsig�at 1 ,t,� pate; j 0 Ti-ma: <br /> Please return coolerlice chest to Geological Technics 141 /�� Rev. 5.103 <br />