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mm mew ■■. .■. .■. I.. � <br /> 0 0 CHAIN CUSTODY WORD <br /> � Advanced <br /> -, <br /> GeoEnvironmental, Inc. 2 r5�t 7 � �� �'�,'` Date Page 1 or—L <br /> 4005 North Wilson Way-Stockton,Caldonnia-95205-(209)467-1006-Fax(209)467 1118 <br /> Client--Z"As Protect Mana r <br /> Tests Required <br /> P one Number <br /> Samp rs (Signature) Invoice <br /> Protect Name /4(,C# 4,' �. AGE .Q' <br /> K e. Client ❑�i/ t.1CfIYl� � <br /> Sample Location Sample Type No of <br /> Number Description Dale Time Water Air Solid Conts `� _ Notes <br /> Comp Grab t ! <br /> l� ft51Z8moo yl� <br /> / 7) 8 0 , <br /> _w _ µ <br /> l I <br /> Ll lyk <br /> i y <br /> 65183 <br /> i t <br /> Relinq a e` 'IF aReceived y (Signature) te1T{ <br /> Relinquished by (Signature) Received by (Signature) 7 Dat Ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signalure) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laborato5py C [Time <br /> cO alil)a <br /> Method of ShipmentLaboratory Name <br /> __ aal &�r� - <br /> Special Instructions {C ie �h,� }� � i reby orixe the per rma ice of the above Indicated work <br /> PRESERVATIONV _ E <br /> 1 ION R AK <br /> 11EAD SP,"' ' - IT ✓' Cr ,I ' ^ I <br /> f G <br /> fryY)tC-'j C,rfrlr( Y p� lL?t - <br /> `r <br />