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t_ � � � � � 1• � � � � � i� i� 1• t� � t!i tt� <br /> CHAIN F USTODYEC <br /> l <br /> Advanced ORD <br /> GeoEn�ironmental, Inc. <br /> Date G Page of t <br /> 4005 North Wilson Way-Stockton,Callfomia 95205-(209)467-1006-Fax(209)467-1118 <br /> Client ProMLep ar►ager Tests Required <br /> zal:::t <br /> P ne N ber <br /> �67 AWL <br /> am s Sign ure) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Type 1 <br /> Sample Locati n Date Time Water Solid No of Notes <br /> Number Description Air Conts <br /> Comp Grab <br /> 7' <br /> F40 0%6s4ee43-;nkf L-- <br /> o ` 50158 �r <br /> �l i� vl riiJ lL1'A r4l <br /> Rel rn s tgnatur Received by (Signature) atelTrme WO <br /> A# 71WLI I de <br /> V <br /> Reil urs ed by (Signature) Received by (Signature) PatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> siz <br /> Dispatched by (Signature) Date/Time a ived for ab ratory by ` Datefrime <br /> Method of Shipment Laborator N e <br /> Sp ctat lnstructtons f i hereb au orize t e Porto nce of he above indicated work <br />