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GeoAl ti a ,l Laboratories Ince <br /> i nay - <br /> 1031 Kansas Ave. Phone (209) 57270900' <br /> Modesto, California 95351 Fax #(209) 572-0916" <br /> l` CHAIN OF CUSTODY 5138 <br /> 14 <br /> Client /��C O Phone <br /> S <br /> Address CC to: <br /> Zip <br /> I . <br /> PROJE,CQT IDp _� ANALYSIS G -~ <br /> Of <br /> SAMPLED BY: (si nature) <br /> 5 ers ' df REIu1`ARKS <br /> same e <br /> f ' type Sample ID <br /> I Date Time crec coo. 23 <br /> o�' <br /> ns <br /> Z Y f- cJrr) <br /> i <br /> i Z- 1C <br /> i <br /> i <br /> F <br /> E <br /> FF <br /> Reiinquished•by ature): Date Time Received by(sig ature): Date Time <br /> Relinquished by(signature): _ Dale' Time Received by(signs e): Date Time <br /> _ <br /> Ii Relinquished by(signature):. Date Time Received by(signature): Date Time <br /> t " <br /> Relinquished by(signature): Date" Time Received by(signature): Date Time <br /> j Relinquished by(signature): Date Time Received by(signature): Date Time <br /> I <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> I , <br /> } Mileage Approved By <br /> Garoli Graphics(204)527,3667 - <br /> i <br />