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M i it i <br /> Geologic'!Technics Inc e 7 <br /> 1101 7th Street <br /> Modesto,CA 95354 <br /> (209)522-4119 f fax(209)522.4727 J <br /> geologicaltechnics@sbcglobal net ( L, O <br /> Pro)ect# Cbent/Pro)ect Name y i Laborat(ry Name&Address <br /> MQfLvVA r4 <br /> Site Address I'0 <br /> Sampled by (s nature) ACS —0 <br /> 0 <br /> Date Sample I D a Z Remark, <br /> —26 <br /> r <br /> i <br /> Reunshed b (signature) Date/Time Received by (signature) PLEASE RETURN SAMPLE CONTAINERS Remarks <br /> I <br /> R gwshed byi Lure) Date/Time }R eived b (signature) CC <br /> �y F <br /> des 4 �d''. ; <br /> i ehnquished by isignature) Date/Time ieceive� by (signature) <br /> I <br /> I ` <br />