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P.O. Box 4877 0 Modesto, CA - 95352-4877 - (209) 576-7182 <br /> Soil Groundwater Investigation 0 Environmental Real Estate Audits <br /> Remedial Site Assessment - Remediation Systems <br /> CHAIN OF CUSTODY <br /> Client Phone <br /> Address CC to: <br /> Zip <br /> PROJECT <br /> ID ANALYSIS <br /> No <br /> Z66 of <br /> con. <br /> ED BY: (Signa lain- <br /> ars REMARKS <br /> sI a PI <br /> Date Time SamplJ Location <br /> u i <br /> 0 <br /> M" <br /> s mpl <br /> Pe <br /> Grob Ca". <br /> LL� <br /> I Ilk <br /> to <br /> ton'"IA <br /> Is A,— <br /> hed by (sign a Date Time Received by(signalur Date Time <br /> N Lb <br /> shad by (Qnature): V Date Time '4i-e-ceivJd­by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature), Date Time <br /> Relinquished by (signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by (signature): Date Time <br /> 6 Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish; Tolal.Hours: <br />