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A • CHAIN OF CUSTODNWCORD, <br /> Advanced g.- g .0 Q <br /> Date Pa98 of <br /> GeoEnvzronmental, Inc. <br /> � 4005 North Wilson Way Stockton,California 95205 (209)467 1006-FaX(209)467-11 iB <br /> Project Manager Tests Required <br /> Client 14��I`yr M ` (<1 <br /> Phone Number <br /> 7oq - 4b 7` Ipts <br /> Samplers (Slgna,Xute) ���e invoice <br /> "fA-W ;At AGE <br /> -jj ❑ <br /> PrnlectName C � C � ;~ <br /> �ir� � T � MUcli`5�� � Nr Client <br /> Sample Type <br /> Sample Location Date Time Water Solid No of �.� Notes <br /> Number Description comp arab AIr Conts <br /> 30808 <br /> + Kw _ 0, <br /> Dale Ime <br /> �e inquis e y ignature aces e y rgnature S rgVl Owc� rr Ij • �,`� <br /> 1W �/�i�j-� � Date/Time <br /> Relinquished by (Signature) eceived by (Signature) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> DatelTime <br /> Dispatched by (Signature} <br /> DatelTrme Received for Laboratory by DatelTime <br /> 0&GETAES OTHER Laboratory Namef <br /> Method of Shipment fy ��Z1i �i <br /> CA overlii (t_ ICEIi� <br /> rize the performance of the above indicated work <br /> Special Instructions OD CONDITION APPROPRIATE i hereby autho <br />