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Advanced CHAT� 'OF CUSTODY CORD I <br /> GeoEnvironmental; Inc. } <br /> ,.- date Page <br /> of Northern California <br /> 1803 West Ma' Lane,Suite A-Stockton,California-95207-(209)956 0264-Fax(209)956-0700 qg }�06r � <br /> Project Manager ,I <br /> Client G Ck S �t� Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> AAGE <br /> Project Name / � C enf r <br /> 1 <br /> i t <br /> Semple Location Sample Type No of Notes <br /> r <br /> Date Time Water bli� <br /> Number DescriptionAir Copts. <br /> Comp. Grab. <br /> I k <br /> 17 <br /> WA <br /> �. <br /> k OAS 0& I FETA <br /> N <br /> G00 CONDITION A <br /> AEE ABS NT CONT NER$ <br /> Helirquis a y: igna ure Receivedy: (Signature) Dale(Time <br /> 111 00 <br /> Relinquished by: (Sig* } <br /> nkature) RecaAd b%: Sigdatrhe) Date/Time <br /> I <br /> CA OVERIr1l 8L�j t KAE � <br /> Relinquished by: (Signature) RecWved by Mobile Laboratory for field analysis: (Signature) DatelTime <br /> 0 <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Dale/Ttme <br /> � � A <br /> Method of Shipment. �� ,W� + Laboratory Name / / <br /> el.0t <br /> CA <br /> Special instructions: 1 hereby authorize the performanc4 bf the above indicated work. k <br />