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{ �77�tr Condor Earth Technologies , Inc . <br /> CIHMN�O RC V 3 ODY 214563 Roan is»e (] 1125 North Golden Siatr HImIcvwd 188 crank Vhst Circle, Suite I <br /> P.O. Box 3903 Suite 0 6tociw% CA 45206 <br /> 3 5 5 7 Sabra, Caiifomia 93370 Turlock, CA 15381 209-234-05 18 <br /> r4+�LI; ,.ik.O, L 2..154-572-0361 2119-668-9236 209-2340538 (fax) o <br /> UI "' y�, ro ` ! ' tl .D)•� i �. fll ""tl "f L' 209-532-0773 (fu) 209-66&7357 !fax) eendc.@mhdorawdaoa.eom (0nwl <br /> SHIPPED TO: } SEND RESULTS TO : <br /> 6xCActne.+n NAME : <br /> . -SOD G '%9A9Ppe UtICt 6LA& 3 OFFICE: OA16 F� kA�et h- Gif], ete. � 5u 1e <br /> R es 10 CCom, R 5( 1 19 <br /> PLEASE FAX RESUL'T'S : z PROJECT: 1 tdd5 LOT* ti .�ws� -Paci�tic �oexu�' l <br /> PROJECT NO. — <br /> NCI. t ✓ Veliflcatiorl <br /> con / <br /> (Signature) G . C � - ' <br /> Date Time Sample SD ers - �f REMARKS : NHSC. z <br /> NMI 3 <br /> . g ��7�Qt <br /> � Ckl <br /> z'i ok lrro2-Re7- 1 mo. kaz 3 IN 1, 001l <br /> 9 2 $ ibt t -6 � o3- 17 2- N - 47-00 -ga3 3 . , --- - � ist n „ zrr R' <br /> 14li 'FLy „11 � <br /> ;-- <br /> t <br /> l <br /> RelirlWis(:eil By- Time: Received 8y: S oYy by 8z Bate -Time a <br /> C" I (Signature) y <br /> Relinquished By: Datc: Time Receaved B}•. — - --- Date: 1 Time: <br /> 1 (5rgnature) I (Signature) –• <br /> l -Relinquished By: 1 Dute: Time: Received By: �Cfl( .'• Date: [ Ti <br /> - > <br /> � <br /> L3riginaJ-Sail `- - — - - -- S"elkrvv -File g - Pink-Log Bnuk — <br />