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Lab Report# <br /> GeoAnal tical Laboratories, Inc. <br /> y Regulatory Yes ❑ No yLi <br /> i&red IM, 1405 Kansas Avenue Phone: (209) 572-0900 Regulator: <br /> Modesto,CA 95351 Fax: (209) 572-0916 <br /> Phone: ('tel) <br /> Client: a1�� CHAIN OF CUSTODY rax: (00r) I �� <br /> Address: <br /> i� JU Gft' �. 1 o. GL <br /> City �t' rr-6'� Zip y�:2Y(7 <br /> Project IU ! e' _ ����'J �� ' � Lab Use Only <br /> (Print Name) r y <br /> ( Sampled By Q, ,Q <br /> (Signature) Container U � <br /> k <br /> Sample type �� �(� V� �G Lab ID# P <br /> Grab Comp Matrix <br /> Date Time Sample IU •Type Size ! �` 0. <br /> j•6 Remarks 1pa y_ <br /> it'.ls �7fr►G . i.L/� -•�--- � � � SSS <br /> ;Z <br /> Remarks <br /> Relinquished by(Signature) Date Time ec i I (.' Date Time <br /> Relinquished by(Signature) Date Time teceived by(Sign. ure) Date Time <br /> Preservative: 1Q-4°C 2&HCI 3Q-NaOH @-Na2S,O, D-HNO, ©-H2 O4 (D-Other &Other <br /> Site Time: �� � StartDriving Time./ /yy Total Hours <br /> Stan: inislt: Total Hours: Site Arrival: x2= N�5 �� <br /> • Mileage: X-2 79245 Approved By: <br />