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CHAIN OF CUSTA RECORD <br /> ( Advanced n <br /> GeoEnvronmental Inc. Date y � Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467.1006-Fax(209)467-1118 <br /> Project Manager <br /> Client �w Tests Required <br /> WSA T <br /> Phone Number <br /> Samplers: (Signature) <br /> Invoice: <br /> . ,..._ � <br /> Project Name AGE Client ❑ <br /> Sample hype <br /> Sample Location Date Time Water Solid No.of HCl Notes <br /> Number Description comp. Grab. Air Conts, h� <br /> L r X 1 19820 <br /> a <br /> 19821 <br /> T-9 <br /> 982119bf <br /> 982'3 <br /> :1.982.4 <br /> Nr� — 14,3 9825 <br /> lqg6 19826 <br /> e inqu s e y: (Signature) ecerve 7y (Mgnature) 9/2Z f 14 Dale!irme <br /> Relinquished by: ( gnatute) Received by: (Signature) <br /> 1 � ,v DaleJTime <br /> Relinquished by: (Signature) jGE/Io Received by Mo �rp gtlr,ftgr�i� ()alysis: (Signature) Date(Time <br /> U IVIS IHLJ 1{ <br /> Dispatched by: (Signature) GOOD <br /> c ONDITIaN APPROPRdAT a Received for Laboratory by: Date[Time <br /> Method of shipment .EA — NE Laboratory Name <br /> M c <br /> Special Instructions: � � _ � 1 hereby eutholiz the performance of the above Indicated work. <br /> Tom►''/(yJ �- <br /> t7 <br /> I <br />