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CHAIN OF CUSTODPRE <br /> Advanced CORD <br /> ---_ , GeoEnvironmental Inc. Date Page _� of-1 <br /> 837 Shaw Road - Stockton, California - 95215- (209)467-1006 - Fax (209) 467-1118 03 _ <br /> Client ��� �i� ,n A Project Manager Tests Required <br /> Phone/R1�Number <br /> 4 t .. <br /> r <br /> Samplers: (Signature) ;� Invoice: <br /> Project Name (� i ( A� AGE <br /> Client <br /> Sample Location Sample Type <br /> Date Time Water Solid No. of Notes <br /> Number Description Air Conts. <br /> Comp. Grab. <br /> rob- <br /> I xe I <br /> e inquis a ignatur eceived y: (Signature) Date/Tin e <br /> Z 1163 <br /> Relinquished b): (Signature) Received by: (Signature) 0 <br /> Date ime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) �. Tr Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laborator Date/Time <br /> Method of Shipment: orato Name��p <br /> QZ r C. L 1 �- <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />