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CHAIN OF CUSTOS f��AECORD <br /> j Advanced Date Page of� <br /> -- GeoEnvironmental, Inc. <br /> 837 Shaw {load - Stockton, California- 982151-(209)467-1006- Fax (209) 467-1118 <br /> Client P Manager t Tests R quired <br /> P umber <br /> it <br /> Samplers: Signature) �� Invoice: <br /> KProject Name -1-4'4 , AGE <br /> 1 Client ❑ <br /> Sample Location Sample Type No.of <br /> Date Time yVeter Solid Notes <br /> Number Description Comp. (arab. Air Conts; <br /> ti �3� �� XY YIX I <br /> ops qY <br /> inquis a V. I ure) Received by; (SignaliUM) Dat.ITim <br /> Relinquished by: gnature) Received,by: (Signalure) DatefTials <br /> Relinquished by: iSigneture) Received by Mobil*Laboratory for field analysis.(Signature) Datefrime <br /> Dispatched lay:.{Signature) DatelTime. Received for Laboratory by: J Datelrime . <br /> t Ci'1 <br /> Method.of Shipment: Lab tory Name <br /> Special Instructions: i // ` I hereby authorize the performance of the above indicated work. <br /> �AV� ttrY r�� �it'6 <br /> +� <br />