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Al01 F <br /> Geological Technics Inc. <br /> 1101 7th Street <br /> Modesto,CA 85354 <br /> (los)5224119!Fax(los)522-4227 <br /> Seo log is a It e c h n ics @s h cglo ba S.nei - <br /> jestIt Client/Project N e r . <br /> Laboratory Name&Address <br /> Site Address- <br /> Sampled by: {signature) U Q' <br /> Date Sample I.D. Z Remarks: <br /> lid,. �1nL "3 t tF1R �Cl� [?:blew hC.,I, C. <br /> A <br /> s" <br /> 4yt - <br /> Relingws e�y: (signature) :Date/Time Received by: (signature) PLEASE RETURN SAMPLE CONTAINERS Remarks: <br /> p a w /0jo a- ., <br /> R,. inqu shed by: (signature) Date/Tune RRec ived by: (signature) CC: <br /> Relinquished by: (signature) DateF ;/Time Receive&6y: (signature) <br /> I I .. <br />