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I t I i <br /> Advanced <br /> CHAIN OF CUSTODY AEC RD <br /> -- GeoEnvironmental, Inc. Date Page <br /> --- <br /> 837 Shaw Road - Stockton, California- 95215 - (209) 467-1006 - Fax (209) 467-1118 0.5 <br /> Client Pro Man ge <br /> Tests R ired <br /> Phone Number t <br /> WD 6Z /00 .� <br /> lers: 'gnature) , '� Q Invoice: <br /> Project Name AGE,12/ <br /> Client ❑ <br /> Sample Type ! r <br /> Sample Location Date Time Water Solid No. of /� ,, G' Notes <br /> Number Description Comp. Grab. Air Conts. <br /> TA 1 l, 6)2Z)44 v l/z <br /> e; q e Y. natur Received by: (Signature) ;2' <br /> ime <br /> Relinqui ed by: (Signatur J Received by: (Signature) D/.[Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Datelrime <br /> S� <br /> Dispatched by: (Signature) Date/Time Received for Laboratory Date/Time <br /> S- z <br /> Method of Shipment: borator ame 1 <br /> Special Instructions: �r I here authorize the performance of the above indicated work. <br />