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m 1• i_ �� itiiii wl■ ttttlttt� �� <br /> J <br /> Advanced CHAIN OF CUSTODAECORD <br /> � <br /> GeoEnvironmental, Inc. OSD 760 Z, Date 3D-,63 Page _- of <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006 - Fax (209) 467-1118 <br /> Client p,1 r, r 6<e, Prole Mane e Tests Required <br /> Phone Number <br /> Sam lers (Signature) invoice <br /> Project Name AGE [R- <br /> !�-�,' Client <br /> Sample Location _ Sample Type <br /> Dale Time Water Solid No of 3 Notes <br /> Number Description Comp Grab Air Cants <br /> K&J`t /Y 5611 <br /> �^UJ I Lk 6,wio,o3 MIA IL lJf <br /> 13oo <br /> Relinquished by (Signature) Received y (Signature) Data/Time <br /> (w " ,A"- -0 <br /> Relinquish a y (Signature) pike Dale(Time <br /> Ralinquished by -(Signature Received by Mobile Laboratory for held analysis (Signature) Dateffime <br /> k - <br /> 4 <br /> Dispatctf -- Datef ime Re d r ratory by �. Ime��++ <br /> Method of Shipment - sboralory a <br /> C <br /> Special Instructions � ����� ��� �/ _1�f I�� i her uthorize JKe performance of Ihs ova trrdicaied work <br />