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Condoarth Technologies, Inc. <br /> CHAI F-CUSrrODY ❑ 21663 Brian Lane 188 Frank West Circle, Suite I <br /> NO 4797 P.O. Box 39051 Sonora,California 95370 Stockton,CA 95206 <br /> 209-532-0361 209-234-0518 1 D <br /> 209-532-0773 (fax) 209-234-0538 (fax) <br /> 1-14 !r info@condorearth.com(e-mail) condor@condorstockton.com (e- <br /> SHIPPED TO: SEND RESULTS TO: <br /> Excer< chN X0(73 NAME: R I�tr ssC <br /> Rasev�"11� C� .< ,�oovlat OFFICE: s c / <br /> ❑ PLEASE FAX RESULTS: PROJECT: <br /> PROJECT NO. t707 NO, ✓ Verification <br /> of <br /> SAMPLED BY: f con- <br /> (Signature) <br /> o <br /> (Signature) /o�,,t�'' G/�I' con- i <br /> [ain- Q` <br /> Date Time Sample ID ers /�� 4 REMARKS : MISC. <br /> to s o2 IaQ:> 1 - v4 --I0 s 2_ �3iri <br /> Relinquished By- Date: Time: Received BY D telI: Time. <br /> I Q <br /> (Signature) �"I'N %leI if j 1 D (Signature) D b �2 1 •9 F <br /> Relinquished By: Date: Titne: Received By: Date: Time: <br /> (S+ nature) (Signature) <br /> Relinquished By: Date: Time: Received By: Date: Time: <br /> (Signature) (Signature) <br /> Original-Send Yellow-File Pink-Log Book <br />