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i• I• � � � � � >• fi• ■�■� � ffi• � � w■�■ t�liw� ittttt� ittttttt� tttttttt�■ <br /> j <br /> CHAIN OF CUSTODYAECORD <br /> Advanced <br /> --- GeoEnvironmental, Inc. °�$ `)Le , Page of Z <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1006 Fax (209)467-1118 <br /> Client r Project Manager <br /> lTests Required <br /> �, <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name / / � 1� AGE <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Alt Solid Cants Notes <br /> Comp I Grab <br /> c' <br /> e in ished pignatur Received by (Signature) ate ime <br /> Relinquts e y ignatute) Received by (Signature) �' D#keffime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysts (Signature) Date rime <br /> Dispatched by (Signature) Dateffime Received for Labo tooy bb Date/Time <br /> I;4LI a- 2 7.140 •ro <br /> Method of Shipment Laboratory Name <br /> I <br /> Special Instructions I here y authorize the performance of the above Indicated work <br />