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Geological Technics Inc. <br /> -- 2741*rr 7,ead _ <br /> Modesto,Cafifornia 95351 <br /> (209)538.6424/77ox•#538.5852 <br /> Project# Client/Project [Mame w <br /> Gv s' y L Gc ,j yah Laboratory Name&/Ad/dress <br /> Site Address ;� s` t 4,c, c� G Sys <br /> 1271? x- 111,x lao U <br /> Sampled by: (signature), <br /> yam/' <br /> Date Sample I.D. Z hJ Remarks: <br /> Th 3 <br /> 3717i9� r� - i �/J/ <br /> 7,292 Fk 2- <br /> 9F IA-- L 5 13 <br /> 3 /1719 4 3-P Z 131 <br /> 3 srf- 2-1 "ex IX X <br /> '117, <br /> ?q CC's,•pc. /C ! .� <br /> ' qV <br /> R quished y: ignature) Date/Time RieceiJvod by: (signature) PLEASE RETURN SAMPLE CONTAINERS Remarks: <br /> 4-71�F, <br /> R 'nqui hed by: (si ture) Date/TimeReceived by: (sia me) CC. <br /> Tfl A-/f� i/34 <br /> °w elinquished by: (signature) Date/Time Received by: (signature) <br />