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a_ t� fifflfffffA I� I� tf� t� I♦ 11M 1101IIIIIIIII 1=1 <br /> ( Advanced <br /> CHAIN OF CUSTODOKECORD <br /> __- GeoEnvironmental, Inc Date 5t-2q- Page 1 of <br /> 837 Shaw Road- Stockton, California- 95215- (209)467 1006- Fax (209) 467-1118 O 1--f _0 <br /> Client Project Manag Tests Required <br /> Phone Number <br /> Samplers (Signature) ��i Invoice <br /> Project Name Sle4r.- -*2 AGE <br /> Client ❑ <br /> Sample Type <br /> Sample Location No of <br /> Number Description Date Time Water Air SolidNo <br /> �a Notes <br /> Comp Grab <br /> t©c 9 t Gdti <br /> IJ�'�wq-ZD t <br /> to 1r? <br /> It Z.9-" 92 I <br />� rM,wq-3r� tt 3©t °IZS <br /> e i is y ( ig r eceive y ignature DatelTime <br /> 5-24-0s-f <br /> .401"elinquished by (Sig ature) Received by (Signature) STAT Date rime 30 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datef ime <br /> Dispatched by (Signature) DatelTime Received for Laboratory Dater <br /> 7T <br /> Method of Shipment /t ` S Labo ry Name <br /> L/�_ 1l r i�Jfr <br /> Special Instructions I hereby autho ze the performance of the above indicated work <br />