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P.O. Bo*769$1-6981 <br /> M.J. Kloberdanz & Associates Modesto, California 95357 Lab Report 4 <br /> Environmental Services Phone: (209) 577-8186 <br /> Regulatory ❑Yes ❑No <br /> Fax: (209) 577-8158 <br /> Regulator <br /> Phone ( } <br /> Cheat �—� G(Sb CHAIN OF CUSTODY Fax ( ) <br /> Address _� C65 To <br /> City 92.la-Lic-c=- Zip ----- <br /> Project 1I? Lab Use Only <br /> i(Pn N e) N <br /> Sampled ByiYn�a ) �u.,.-�- Q Z <br /> Container Q / Lab ID# w <br /> Samp}e ti,,fe <br /> DateTime Sample ID spa z <br /> Grab Com U-tauc yp" <br /> Remarks <br /> er"/0 ' / I <br /> r <br /> 41 <br /> � h � <br /> r� <br /> 21 <br /> r <br /> ee- <br /> AO kqr <br /> a <br /> t LU 1 1,0% <br /> P emarks <br /> Rail mly g re} Dada Time Races by(Slgnaltrro) Date Tune <br /> -o _A � ; a0 <br /> Ret,nq by(Signature) Data Time sued by(Srgnal e) Date Time <br /> Preservative <br /> Site Time Driving Tim Total Hozs <br /> Staff Glnleh foul Hou,+ Stall Site Am•al A2 <br />