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o?,C 1164 0 <br /> Advanced CHAP O CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date page <br /> 837 Shaw Road- Stockton.California-95215- (209) 487-1006 Fax(209)487-1118 <br /> Client 1 Prosect a ger <br /> t� fTests Required <br /> t z <br /> Phone Number <br /> C i�lioj 00 C <br /> Sam ars (Signature) Invoice <br /> Project Name � � AGE <br /> ro / Client ❑ <br /> Sample LocationSample TypeSolSolido of <br /> Number Description Date Time Water Air Conts Notes <br /> Comp Grab <br /> mtiu - o <br /> � � x <br /> Olin Q iu,"AL'Iir r <br /> Re inqu y nat re sce y gPa r Date/Tirn <br /> Rel+nqui had byignaturs Received by (Signature) Date/Time, <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTlma <br /> Dispatched by (Signature) Date/Time for Laboratory by Gale/Time <br /> Method of 8h1prt►ent Laboratory blame <br /> A 04V 11 <br /> Special Inalrucdons I hereby au t xe the follmanee of the above Indicated work <br />