Laserfiche WebLink
• Lab Report# J 3 / <br /> �-- GeoAnalytical Laboratories, Inc. <br /> Regulatory C3 Yes O No <br /> 1405 Kansas Avenue Phone: (209)572-0900 Regulator: lAQ-+ k-vteA, - J�a..vy.. <br /> Modesto,CA 95351 Fax: (209)572-0916 <br /> Phone: ( ) <br /> Client: W r t A k A- r d >n Mo- 1,�-a.� CHAIN OF CUSTODY Fax: ( ) <br /> Address: Al F_ to}k S+ To: <br /> City -ryae CA, zip 95'37(p <br /> Project ID E Z GA5 Mt N i MART /4/oI /11AI)u s-r rSCAL6P,CA Lab Use Only <br /> (Print Name) ~� <br /> Sampled B <br /> l A Y <br /> (Signature) Container o <br /> w <br /> Q ' <br /> Sample type o � � � A. Lab ID# <br /> Date Time p z <br /> Grab Comp Matrix <br /> Sample ID lype Size <br /> P- f -f •l; J� RY6 Ix Remarks ` - <br /> /o.'22 1 1 P-3 / x x ;< sc <br /> ;< x x J 35 <br /> 11 <br /> / x �� iS -5 <br /> 3 -6 <br /> Remarks <br /> Relinquished by(Signature) Date Time R ei (Signature) Datgg Time <br /> 3 '.15 t,�� Y(24 31s <br /> Relinquished by(Signature) Date Time Received by(Signature) Date Time <br /> Preservative: @-40C (0-HCI (@-NaOH @-Na2S20, Q5 -HNO3 ©-H2S 04 7Q-Other ®-Other <br /> Site Time: I Driving Time: ; Total Hours <br /> Star: <br /> Start: Finish: 1 p0 Total Hours: i Site Arrival: x2=1 <br /> Mileage: (2 0 M;ke N Approved By: <br />