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• CHAIN OF <br /> CUSTODY9CORD <br /> ( Advanced Dat �30 Page --4—of <br /> GeoEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Protect ria art Tests Required <br /> Client �, �, � � f <br /> P ne Number <br /> C C <br /> Invoice <br /> M ' (S, lure <br /> } t AGE 0 <br /> Pll( , Client ❑ <br /> Protect Name <br /> l Sarriple Type No of / Notes <br /> Sample Location Date Time Water Solid <br /> Number Description p Air Conts <br /> � corn arab 60047 <br /> -►1 Y ' 60046 <br /> 5 U 60649 <br /> 60054 <br /> 0 ' 60051 <br /> �! V ` 05 <br /> 60053 <br /> e rnqu s at Ig tura <br /> ecety y gnatura � � �� <br /> atalTime <br /> Relinquished by ignatura) Received by (Signature) <br /> Qate(Time <br /> Received by Mvbtte Laboratory for field analysis (Signature) ---��- <br /> Relinquished by (Slgnalure) ; � <br /> Received for Laboratory by �G elTtme <br /> DatelTime �/' /f � r f S7? <br /> Dispatched by (Signature) �' p l�° ��" <br /> p ! abor o y Na e i <br /> "thud of Shipment �� � � . ,,�, <br /> "L <br /> ! here y au hor,ze the perlormartce of the above Indicated work <br /> Special Instructions <br />