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Geological T`echnic5 Inc. <br /> 2741 94w RVad <br /> !Modesto,Ca&fonua 95351 <br /> x209)538 642419aq#538 5852 <br /> Project# Client/Project Name ' Laboratory Name&Address <br /> Site Address <br /> Sampled by (signature) t c <br /> �G�-►r <br /> Date Sample I Da 2 '" Remarks <br /> q� <br /> I � �:� � i +`.e ���' ' � � � ! ��c- gf-I v� w'�—'�"'��i9� #�� -tet �a 3 �► <br /> Cc� <br /> --7 <br /> a <br /> J� <br /> J{p! <br /> Relinquished by (signature) Date/Tune Received by (signature) PLEASE RETURN SAMPLE CONTAINERS Remarks <br /> ReLriquished l;y (signature) D_ate/Tune /Recetved by (szgZature) CC <br /> "I i � f ( J <br /> �.t�J r`i /(.�r'�.3 � i �.�i�C... T7�-•Y��i�fii <br /> Relinquished by ('signature) Date/Tune Received by (signature) <br />