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(�- Advanced CHAT O CUSTODY REC RD <br /> GeoEnvironmental, Inc. Date Page <br /> 837 Shaw Road-Stockton, California- 95215 - (209)467-1006- Fax (209)467-1118 <br /> Client Project Ma ger <br /> K Tests Required <br /> one N ber <br /> (S- <br /> Project <br /> : ature <br /> _ -- - <br /> Project Named IrnoiAGE <br /> Sample location Sample Type <br /> Number Description Date Time Water Solid N Notes <br /> P. Grab. Air Cons. <br /> U r- <br /> 7, 0 <br /> 0 <br /> 0 3 > \ <br /> e mgws a111 y: qgnurs <br /> scene y: tgnature <br /> Date/rum <br /> Relinquis ed by: ( tura) <br /> Received by: (Signature) <br /> Datorrlme <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> Dis etched b T Data/Time <br /> p y: (Signature) DateRime .Received for Laboratory by: r7 L+ <br /> C Dab/ri <br /> Method of Shipment: I •�+� _i r, 7oC!_— <br /> Laborato. Name <br /> special Instructions: <br /> I hereby auth ori 9 the erlarmanc of the above Indicated work. <br />