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ii � � i• � i• i i � i• � � � fi fi i• <br /> Advanced CHAIN OF CUSTOAECORD <br /> � <br /> GeoEnyironmental, Inc. Date-R-V-05 Page I of—L- <br /> 837 Shaw Road-Stockton, California-95215-(209)487-1005- Fax (209)467-1118 <br /> Client D k i VEL Ti AA- kj"> \ t'o Protect Manager <br /> W�i i�#-� L Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> AGEa <br /> Project Name �S`� �Gi-� Client p <br /> Sample Location Date TimeSample Type Solid No of Notes <br /> Number Description Com titer ab Air CoMs <br /> -I0 2i ' t, 2Z'1s ,iti d --4o 21_Q 5 104- 3C 5 Y IYIX X <br /> UT ro-13S�% i A �3 5� s` w ff=10 t OM, X S <br /> nt44 5 <br /> e inquis e y ( ignature Receivedy ignatlurs Data ime <br /> Reli uished by (Signature) Received by (Signature) Dat (Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis ( e) S `T- A- T. Data/Time <br /> Dispatched by (Signature) Data/Time Roe eiro r bo by Oat /Time <br /> n <br /> r : e <br /> Method of Shipment Laboratory Nems <br /> CAL- �vG-�-N�C �-- 64"L- -TC-C-K <br /> Special Instructions i hereby authorize the performance of the above indicated work <br />