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t t t t t i t ! fi t t t l t t r r <br /> Geofogicaf Technics Inc, <br /> 2601 fiver&ad <br /> Modesto,Ca4fomia 95351 <br /> (209)538-6424/Yax#538.5852 <br /> Project# Client/Project Name rA <br /> y Laboratory Name &Address <br /> Site Address 4 <br /> 0 <br /> Sampled by: (signature) i o <br /> 0 <br /> Date Sample I.D. 2 Remarks: <br /> Relinquished by: (signature) Date/Time Received by: (signature) PLEASE RETURN SAMPLE CONTAINERS Remarks: <br /> Relinquished by: (signature) Date/Time Received by: (signature) CC: <br /> Relinquished by: (signature) Date/Time Received by: (signature) <br /> I <br />