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� l• >• � l• � i• f� f� � � t;, t•� s wl�i �� is t. t. <br /> CHAIN OF CUSTODOECORD <br /> � Advanced �I <br /> - _- GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road - Stockton California-95215- (209)467-1006- Fax(209) 467-1118 <br /> Client Pro act Ma er <br /> tr` � e.�'�t�� Tests Required <br /> Phone Number <br /> AP6 7 16 0 � <br /> Sam rs (Signature) Invoice <br /> Project NameAGE <br /> '-trjjr,t4 dc., Client ❑ <br /> Samle <br /> Sample Location Type No of ,� Notes <br /> Comp Grab <br /> Number Description Date Time Water Air Solid Conts �} <br /> N fol i( `i�r u OMIL <br /> 6 <br /> fo b163 <br /> WJAI ►J1 u t65 I I l <br /> 1110,70 Iliq <br /> lit <br /> e g is e y (Signature Received by ignatura Date/Ttme <br /> Relinqutshed by (Signature) Received by (Signature) Datefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Dale/Time Received for Laboratory Dale(Time <br /> :f< WI A `t <br /> Method of Shipment � r ab Foto/ <br /> L <br /> Special lnsttuct,onsU 1 hereb authorize the performance of the above indicated work <br />