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Advancers CHAIN F USTODY RECORD <br /> ( , <br /> Ge©Environmental, Inc, � � Page � ` � <br /> 837 Shaw Fload•Stockton, California-95215-(209)457-1005-Fax(209)467-1110 <br /> Client � , Prrct Manager <br /> Tests Required <br /> P e umber <br /> Safnp : (Signature) Invoice. <br /> Praject.Name AGE <br /> client (J <br /> Sample Type <br /> Sample Location Na:of � <br /> Number Description late Time Water Air Solid Corps. ��' � Notes <br /> comp. Grab. <br /> �I �a <br /> Reinqu y: r Received by:. [QnaSure - D !T' e <br /> Relinqu shad y: Signature Received by: (Signature) a1 /Time <br /> Refinquished t>y: (Signalure) Received by Mobile Laboratory for field analysia:(Signature)` Bater'rinte <br /> Dispatched by:(Signature) D.Alefrime T_Ceiwd tot Laboratory by: Date/Time <br /> Method of Shipment: Letior ry <br /> special Instruction. I hereby aut xe the per rmance of the above indicated work. <br /> G <br />