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• • 0 <br /> t Advanced �'Z CHAIN OF CUSTODY RECO <br /> 1 ✓ � <br /> - GeoEnvironmental, Inc Date Page Z— of <br /> 4005 North Wilson Way Stockton,California-95205-(209)467 1006 Fax(209)467-1118 <br /> Clienth (� `F� Project Manager ` Tests Required <br /> 1�6 Ft->f— 7-h <br /> Phone Number <br /> AE UVB <br /> Samplers (Signature) Invoice <br /> AGE <br /> Protect Name ( l 7� t/ w Client a <br /> azld <br /> Sample Locati n Date Time Sample Type No of Notes <br /> Water Solid <br /> Number Description comp crab Air Conts <br /> �UV77 <br /> 1n Thr 7 <br /> elinquis ed y ( i natu e) eceive y ,.nature t (rime <br /> a <br /> C� el, , f b �I s� <br /> Relinquished by (Signature) Received l V � r4 Date(T,me <br /> C'hj f Se 62z.qI jolt <br /> Relinquished by (Sign ure) Receive hwllr <br /> i1e L story for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment --C.-b- <br /> hipmentLaboratory Name <br /> I-Vc� 4 /- otC�c ' d� . <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />