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i1 <br /> - 'eaAnalytical Laboratories, Inc. <br /> a 1031 Kansas Ave. <br /> Phone (209) 572-0900 0 <br /> Modesto, California 95351 Fax #(209) 572-0916 <br /> CHAIN OF CUSTODY 5721 <br /> Client JC, -� _ i�;��. <br /> i; Phone �J+ + <br /> Address ; CC to: F <br /> Zip a <br /> t <br /> PROJECT ID ANALYSIS <br /> A o � <br /> SAMPLE&Y. (signature) CC, <br /> C !aim <br /> REMARKS <br /> f,�$ample ` I <br /> I�pe Sample ID <br /> Ih. Date Tirrie I�rao coo <br />! ! I <br /> I � <br /> i <br /> III ! <br /> !' ! I <br /> e ingms y G ur s'" D e Time Received by ( ig re}' 9 a Time <br /> r' � ab <br /> Rtagu ed by (signature): bale Time Received by (signature): Date Time <br /> Relinquished by (signature): Date Time Received by (s+gnature): Date I Time <br /> III" Relinquished by (signature): Date Time Received by(signature): Date Time 1 <br /> Relinquished by (signature): Date Time Received by (signature): Date Time } <br /> Site Time: ;Z :S9 Driving Time: <br /> ',-3tart: Fini h . <br /> Finish:7, <br /> Total Hours: <br /> •G Start: Finish: TGtat Hours. <br /> � S z . <br /> .�� � P 50 3 1 , rj <br /> H n <br /> I Mileage tJ � Approved By <br /> IIS Garoli Grapnits(209)527.3E67 <br />