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{ Advanced CHAIN OF CU ODY RECORD <br /> Dale /4 Ur7 Page <br /> -���---__ GcoEnvtt-onmenlal, Inc, l g of� <br /> 4005 North Wilson Way-Stockton,California-95205-(209)46776-Fax(209)467-1110 <br /> Client Project Mangy <br /> Testsk9equired <br /> Phone Number <br /> r � 1 <br /> Samplers (Signature),. ��-, Invoice. <br /> r <br /> Project Name Y: AGE <br /> UUU <br /> Cliot ❑ <br /> Sample Type <br /> / <br /> Sample L_ocaU n P Yp <br /> Number Description Date Time Water Air Solid Gonts �'No of ` ti Notes <br /> / Comp Grab <br /> t-Z_3 -20 w0 _00 /;5-9 ,leo jd, 3751 <br /> 08 0a Z`oo � � ' 3 751 <br /> � s?C � <br /> S� X xrd .o3751Za 3,q-0 37517 <br /> � <br /> ' 1?c <br /> 37 �cf 3 7 51 <br /> 12-25 0 ! [ 3751S v ood ,¢ <br /> , <br /> Soy c 4 '00 4-fos 3752 <br /> �qurs eby IS! aturel ..... Received y rgnature date lrime <br /> Rehn shed by (Signature) Received by (Signature) - Dele/Tima <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signalure) Date/T e J R or ad for Laboratory by pate/Tlme <br /> V0 £rt't[[ft�S 0JH, r <br /> Method of Shipment _ {lw ri ', mlLe oratory Name <br /> Special Insiruclions �'` r "1�� ny�+'1"V� .... lit��i,i�i�1J I hereby authorize the pefforman of the above Indicated work <br /> 1_r0%SR"r' r ILlLt.r. „ __._._. <br />