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� � I• � � I• � � � f• � f_ i_ �■ t! i_ tf� l!� <br /> •Advanced CHAIN OF CUSTODRECORD <br /> � , , <br /> GeoEnvironmental, Inc. Date `k W - .. Pape oof <br /> 637 Shaw Road - Stockton, California-95215- (209)467-1006 - Fax(209)467-1118 <br /> Client1 Project Manager <br /> � 4 ,r � •'",�, c , ,�` n f t � ,, Tests Required <br /> t �M1 ,fr <br /> Phone Number <br /> Samplers (Signature) Invoice: <br /> •'E— Q <br /> Project NameX <br /> �+ 'Writ <br /> ♦- ' F i } te l 3 ` wx �,� ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of .(} Notes <br /> Number Description comp arab Air Conts tti ij ` <br /> pyo <br /> V <br /> 4 d <br /> k <br /> L <br /> SZ <br /> E <br /> Relinquished y rgnature Received y rgnature Datellime <br /> Relinquished by (Signature) Received by (Signature) Date/Tinto <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatelTime Received for Lafiorato,4 by Date/Time <br /> Method of Shipment Laboratory Flame <br /> Special instructions I hereby authorize the performance of the above indicated work <br /> a � <br />