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f <br /> �► D <br /> GeoAnalytical Laboratories, Inc. <br /> CD <br /> 1031 Kansas Ave. t^ Phone (209) 572-0900 0 <br /> Modesto, California 95351 Fax #(209) 572-0916 <br /> _H <br /> CHAIN OF CUSTODY C,5947 <br /> s � <br /> Client Phone <br /> Address CC to: <br /> Zip <br /> PROJECT ID ANALYSIS <br /> W1 L(,I1/�l C. 1 No. <br /> of <br /> SAM�Y: (signature) con- <br /> tain- <br /> v ers REMARKS <br /> PQ <br /> type Sample ID <br /> Date Time Grab Como <br /> s S 77� <br /> I Z- <br /> 4ewwptsha <br /> d by(si to e): ate Time R eivef by(si ature):, 0 <br /> at Time <br /> ,,,j <br /> Relinq ed by(signature): a( Time Received by slg ): ate 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 /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Fini h: al Hours: <br /> Mileage Approved By xli�"1'1 <br /> Garoll Graphics(209)527-3667 <br />