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GeoAnal tical Laboratkxies Inc. Lab Report# i mat (-o4t. f <br /> Regulatory *yes ❑ No CC: *Yes ❑ No <br /> 1405 Kansas Avenue, Suite "A" Phone: (209) 572-0900 <br /> Regulator: 511V "I.✓ Co• c / <br /> Modesto,CA 95351 Fax: (209) 572-0916 <br /> I Phone: ( ) <br /> Client: > - 1 K 14��-/ Z � CHAIN OF CUSTODY Fax: ( ) <br /> Address: Original To: <br /> City y1h0dLs Zip 1 <br /> Project ID ���( S' r.�l�nJ 2 Lab Use Only <br /> (Print Name) 1 � � �J�� � � <br /> p y !� y <br /> Sampled B <br /> (Signature) Container <br /> >~ <br /> Sample type z° Q' . Lab ID# L <br /> Date Time Sample ID Type Size <br /> Grab Comp Matrix r <br /> 1�7-P-01 'V0 ,v Remarks: j1 9(� <br /> 7'-6"' WW - M1 q97 <br /> L( M <br /> 07o a kl ( K_ t <br /> Remarks <br /> Re.n ui d b (Signature) Date Time Received ignature Date Time <br /> 9 Y B r� 1 1-2U-o , <br /> Relinquished by(Signature) Date Time Received by(Sign re) Date ,Time <br /> Preservative Matrix <br /> Q-4°C @-HCL Q-NaOH Q-Na2S203 Q-HNO3 Q-H2 S 04 Q-Other Drinking Water G)Waste Water 4WHazardous Waste(Water) QSoiVSolid <br /> Site Time: Driving Time: Time Mileage <br /> Start: Finish: Total Hours: Start: Site Arrival: x2=Total: <br /> Turnaround Time ❑Standard ❑Silver Rush ❑Gold Rush ❑Platinum Rush ❑Other: Approved By: <br />