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• Advanced <br /> CHAIN OF CUSTOO RECORD <br /> GeoEnvironmentaI, Inc. Date+f za9Page of <br /> . :4005 N <br /> .". arth Wllxen Way-Stockton,California•95205-(209)487•1006-Fax(209)467-1118 <br /> a x 02593.., <br /> Client -It .1 a Project Manager yF <br /> j[ Tests Required 5.9 <br /> Phone-Number b 7! ,59J�_ <br /> Samplers: (Signature) 1rnl-.0 59.oW <br /> �,�I <br /> Project Name ,�I r. AGE 91 <br /> Sample.`' Location sampleType . . v <br /> -- <br /> Date Time Water Solid No.of ` 0 2 5 9 t <br /> Number" - Description _ _.._ . �, ,� Notes 0 <br /> Comp. Grab. <br /> -Air Cants. �o 14 <br /> .. SgA�fs+O� &A3 Y X K fl <br /> S6-I• rico' .: tQi� K X <br /> fot 7C <br /> yet <br /> 5 —I-31a' <br /> 103p X � �C. ,_. a_Z,598s <br /> Sp` ., toyj� x x X x X1� Z . ,i <br /> Relinquished y g slurs see va y: �n ,e — FIFata me <br /> Rel nqulshe :;Signature) Recelved by: (Signature) D errtme <br /> inria WAS I OR METALS I OUR <br /> Rellnqu shed..y:(S gnature) iia La rat for II d anal sis:(SI nature <br /> e y g } Datefrima <br /> GOOD CONDITION <br /> Dlspatohed 6y:(Signature) T !+n►rrA� 0 at Iteoa ved or Laboratory y: oatalTlma <br /> VU��I+►ulr[fiJ <br /> Method bf Shipment: Jr <br /> laboratory Name <br /> r" �.;. —ed <br /> v <br /> Special Instructions: 'r�7r {� L 1 • + I hereby authorize the per! manoe o! the above Indlaaled work <br /> A „ . <br /> s <br /> y <br />