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GeoAnaiyticai Laboratses, Inc. <br /> Lab Report#_ PZ 65 — <br /> Regulatory ❑.Yes ❑ No CC: ❑ Yes ❑ Nci <br /> 1405 Kansas Avenue, Suite""A" Phone: (209) 572-09002 <br /> Modesto,CA 95351 Fax: (209)572-0916 Regulator: W ' <br /> - W <br /> }� � � Phone: {�) ��� — qZ�SD <br /> Client: W CHAIN OF CUSTODY Fax: 4/ZS�2- <br /> Address: <br /> Addrt ss: Z _ Original To: f{son 4914— <br /> City <br /> 91C.L.,City Zip Reporting: P(EDF ❑ EDT <br /> Project ID 51?�(kk c�I t1V j� Lab Use Oiily <br /> �4� :._...._....._... _............... <br /> Sampled By ......... __..... <br /> (Print Name) . .. <br /> 5 ; . ' <br /> �ICi!f �fI.c <br /> (Signature) Container � <br /> cd <br /> Sample type j <br /> Date Time Sample ID z° t'V Lab'16- <br /> Grab t omp Matrix Type Size <br /> 1�—t I13 )C t,v <br /> G ' <br /> 02— X � RernarksP�C�(Z(jU <br /> • <br /> Ef> -ri 2o.1:. <br /> - i <br /> •T: <br /> ! " <br /> Remarks <br /> 4 <br /> r <br /> Relinquished by(Signature) Date Time Weive <br /> igna )— Date Time <br /> fF <br /> ro-�o� fx:p e -1b- . 2 m <br /> Relinquished by(Signature) Date Time A01- <br /> ignature) Date Time <br /> r <br /> Preservative Matrix '! <br /> Q-4°C Q-HCL Q-NaOH Q-Na2S203 Q-HNO3 Q-HZ S Oa Q-0ther (9brinking Water (DWaste Water(!M�Hazardous Waste (Water) @Soil/Solid <br /> Site Time: <br /> Start: Driving Time: A Time Mileage <br /> Finish: Total Hours: Start: Site Arrival: x2=Total: <br /> Turnaround Time ❑Standard !]Silver Rush ❑Gold Rush OPlatinum Rush 00ther: Approved By: �.M <br />