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*Advanced • CHAIN OF CUSTODY*CORD <br /> i <br /> .- GeoEnvironmental, Inc Date (P-Z5``17 Page of I?- <br /> - of Nonhem Califonuu <br /> 1803 West March!_ane,Suile A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 Qd x n- � a <br /> xs � <br /> Project Manager � �a` <br /> Client �- Tests Re " ��� 9 8° TAY` <br /> ss �. .�_� .� �vW <br /> Phonen�eNumber <br /> � `}M, ���.�;7- 988 <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name J� f 1, � i"` � <br /> w Client ❑ <br /> Sample Type <br /> Samp Ie Location No of {r s - <br /> Date Time Water Solfd <br /> Number Description comp Grab Air Cants rFx <br /> a�T Z, <br /> r S <br /> 8> + o� <br /> -97 Hip <br />�3 3qs5 <br /> Rel inqup e y (Signature <br /> Received y (signature) _26—OTrme��- <br /> - J ra a <br /> Relinquishedby (Signature) Recer Sr$nature) _,D/ _ Date/Time <br /> Relinquished by (Signature) `a lysis (Signature) !�/JJ Date/Time <br /> Dispatched by (Signature) v iltilLl �� 1 !Time Received for Laboratory by DateJTime <br /> 1 r ."SP;rF ASSENT <br /> Method'of Ship ntJ <br /> 0XI <br /> � CD'z�d rim / Laboratory Name �J <br /> 6peciai Instructions\J I hereby author the performance of the above indicated work <br /> /� <br />