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I Advanced Z� �� CHAT O CUSTODY RECORD <br /> GeoEnvironmental, :Inc. Date Page _ of <br /> 837 Shaw Road-Stockton, California- 95215 -(209)467-1006- Fax (209)467-1118 <br /> Client Project M er q <br /> ` Tests Required <br /> umber <br /> - Sa , (SI mature) Invoice: <br /> Project Name �' / AGED <br /> Chent <br /> Sample Location Sample Type <br /> Number Description Date Time Water <br /> Comp. Grab. Alr COmtS. <br /> /17 i iv f <br /> e in s d b06. S i na re eceive y: (Signature) aterrf e <br /> Relin wished (Signbtula Received by: (Signature) I 'Dallefrime' <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) 1� Date/Time <br /> Dispatched by: (Signature) Daterrime Received for Laboratory by: Date/Time <br /> 7 3//?/0 <br /> y <br /> Method of Shipment: �i 1 Laboratory `ma - <br /> Special Instructions: I hereby ■utgayze the erfor ance of the above indicated work. <br /> j �G <br />