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11 APPROPRIATE <br /> +SER tom. 0��v L� � � <br /> VOAS O&C METALS OTHER <br /> *Advanced ;p;,jpfFl�,,� J vA CHAIN OF CUSTODY CORD <br /> 1�Sf'ACEABSFN�.1 9-1 7 <br /> _ __ GeoEnvi ronmental, InC. CONTAIr,tER � date Page of_ -2— <br /> of <br /> of Noniteni Cahfomla <br /> 1803 West March Lane,Suite A•Stockton California-95207-(209)956.0264•Pax(209)95"700 55,67 <br /> Clientbey) " .. Project Man ger <br /> Tests pegctired <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Protect Name AGI= [%Axu-J Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Cants No <br /> M 11-, <br /> �,e} Comp Grab <br /> 1�N1 r�!� 12•fib ✓' <br /> IVIV <br />� �111�?s�Cir -�7 �Z•Ti.S <br /> Akub <br /> I .) <br /> Rel inoi y rgnaI i a si e y -gnat 9 Datefrime <br /> & t <br /> vamol � <br /> Relinquished by (Signature) 42girKed by (Signatu e) Dato Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date(Time <br /> r 1 <br /> Dispatchdd by, (Signatur9) Date/Time Received for Laboratory by Dateftime j <br /> Method of Shiptn t' s ��� Laboratory Name <br /> a,14f <br /> Special Instructions -<J Thereby authorize tfi potformonc8 of the above indicated wort; <br /> AA ` w <br />