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.rat■.a � ttttttttttttr ar: �ttttt� � .r: � .�. antttt� �. �■ aaaw womb <br /> CHAIN OF CUSTODY RECORD <br /> Advanced _ <br /> GeoEn�ironrnental Inc. Date f2 Page of-.:;"--- , <br /> 1 1 <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Project Manager , <br /> Client ( ® C u I/ G Br �� r Tests Required <br /> Phone Number <br /> L.jJ[fJ <br /> E V <br /> 7- 1 <br /> d /f� r <br /> Samplers: (Signature) Invoice: <br /> + o AGE <br /> Project Name Client Q' <br /> Sample Location Sample Type Solid No. °f <br /> Date Time Water <br /> Number Description comp_ crab. Air Conts. <br /> 3 <br />+ 7 - <br />} <br /> 3-35 3 r re ; <br /> V-5 / 5 7- if <br /> W- Lev —Z 7— 211 3 <br /> M k/— <br /> e,n a,d by. (Signature ece+ve y: i nature <br /> Relinquished by: (Signature) Received by: (Si nature) } <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DaterTime <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: 1 Uw <br /> Laboratory Na 1 <br /> a 'P it Vl i ' �+ C <br /> Special Instructions. a1� I Mere y authorize t perlormance of the above indicated work. <br /> ii <br /> vows o&c MFIALs aT Erk <br /> ICI <br /> raGi;�s�r�GC J,�SEi�T � CCrai���l:R5 i! <br />