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CHAIN OF CUSTOD*CORD <br /> *Advanced <br /> -- GeoEnvi ronmental, Inc. <br /> Date Page of <br /> T 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client C C �, Project Manager Q Tests Required <br /> Phone Number <br /> qcD 9- <br /> Samplers (Signature) Invoices I <br /> Project Name J/ C t pp _ ` Client ❑ <br /> L \ K <br /> rJ <br /> r <br /> Sample LocationSample Type Solid Notes <br /> No of � rtk <br /> Number Description Date Time comWater Air Conts <br /> Grab <br /> P ill � <br /> 0%, Uvp .4T 0 9 , P v <br /> z 6516, t <br /> p 1t <br /> ai 5 Rt4 <br /> o <br /> 5nr1 r.l in� P-3 j � 4 <br /> 11 rt ♦� rI <br /> P � <br /> Rel, u ed y ig lure ecerve y ignature D o/T'me <br /> 0'�o <br /> , I <br /> RIP-1 inquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Dale/Time ecerved or Laboratory b DatelTime <br /> Method of Shtpmr3 Laboratory N me <br /> Special Instructions I hereby authorize the performance of Ilia above indicated work <br /> f <br /> S <br />