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CHAIN OF CUSTOMIECO`I1D <br /> � Advanced ` <br /> --- GeoEnvironmental, Inc. <br /> Date Page .A_ Of� -�- <br /> 837 Shaw Road - Stockton, California-95215- (209)467-1006- Fax (209) 467-1118 <br /> ClientaiA�+f— <br /> n <br /> Prol <br /> Prollager Tests Requirede Number <br /> r <br /> SamIers (St nature) Invoice <br /> AGE <br /> Protect Name Client ❑ <br /> Sample Type <br /> Sample Location Date TimeSolid No of Notes <br /> Number Description Water Air Conts <br /> Comp (arab <br /> I <br /> e�nqui y I at e} Received by (Signature) D tafTinie <br /> Relinquished by (Signature) Received by (Signature) Date/Tima <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatefTEme <br /> Dispatched by (Signature) DatefTime Ae raboretor rrr���111 l] terT+me <br /> Method of Shipment RECD SEALED &INTACT VIA � ratorY�a <br /> 1 hereby authorize the perro encs of the above indicated work <br /> Special Instructions GOOD CONDITION �` APP WRIATH, ,..,..._`� <br /> , <br /> HEAD SPACEABSENT CONTAINER-9-;- _ <br /> AECHLORINAT D IN L BVE13 IN LAB- <br /> WAS U&G METALS UTItRR <br />