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CHAIN OF CUSTODY*CORD <br /> Advanced � <br /> Date 07 - 01-le Page -R— of <br /> --- GeoEnvironmental, Inc. x.t�TSa. <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-fax(209)467-1118 <br /> Client 5� Project Manager Tests Requir d <br /> C Q <br /> Phone Number <br /> o �*� Invoice: <br /> Samplers: (Signature) <br /> AGE Eq <br /> Project Name '�'Cq Client E]Serb pigAFfAT, � <br />' � O <br /> Sample Location Sample Type No. of v x <br /> Number Description Date Time Water Air Solid Conts, r / x �� %Q <br /> Comp. (arab, <br /> Me�iFoPiIK� wEfl lin. Z � SArapl� pRA3s � v 1( �f i <br /> /� f\ <br /> I r <br /> s Ff �3s� x AM X <br /> Nawi7p�inF klfll Np. S j5AMpfQ IO: S� � 1' <br /> LL. H <br /> Mogi Torfnti Wflt Nn. I j --Ample 1 r Q <br /> r-alft&h2 4E to t= sG . <br /> � 11' 07 <br /> � , j r� r s E E�-►3s� 4�old �, <br /> M+�,3 - Zp r • � , , zQFcl� <br /> Si`A►vDAR� -9 SDiralelTime <br /> ece+veygnaturenyura a y: (Signature) p._qbAVI 3e o ^ <br /> :3A i <br /> Relinquishe y: ( i nature) Received by: (Signature) Dat JTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Dale rime <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: DalelTime <br /> I <br /> Method of Shipment: Laboratory Name <br /> CA C)a& ti man, VOAS ON I METALS1 01 HM r-C q m 11 Q ' <br /> Special Instructions: GOOD CONDITIONVAHUN I hereby aul orize the perlormance of the above indicated work. <br /> —19!-07APPBOPPiIATE <br /> ale <br /> WD ONTAINt, - <br />