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_ CHAIN OF CUSTODOECORD <br /> Advanced D,�-0 L� S Date 5-1-0 S _ Page �` o� <br /> GeoEnvironmental, Inc <br /> 837 Shaw Road- Stockton,California-95215- (299)467-1006- Fax(209)467-1118 <br /> Client Project>�hbe.r Project Manager Tests Required <br /> ia.k' <br /> Phone Number <br /> I <br /> Samplers (Signature G�� Invoice <br /> Pro <br /> I ect Name V� 4' Q AGE <br /> ���- St's'" �� ��- C7 <br /> Client ❑ <br /> Sample Type '7 <br /> Sample Location Date Time Water Solid No of �� 1 , Notes <br /> Number Description Comp Grab Air Conts <br /> se- <br /> S 2-oS Q$S5 <br /> rMWI-1S t( ioct�� <br /> ( -2© It 2t�� � lL <br /> rMtvl 2$ ti oglS <br /> f�1�U1-3e i 30� C3(Lza <br /> 3 S{ cgzS <br /> t~3 S u i7ate11'tme <br /> ,;i <br /> Onq <br /> s aigna re} ecetve y ignature5V-oS /l`�Opiished b Signature) Received by (Signature) DatelTtme <br /> Relinqutshed by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dtspatched by (Signature) Date/Time RecMdorabor ory by _)7713-t./T'7„ <br /> Method of Shipment Laboratory Name C'J <br /> Special Inatructiona I hereby authorize the performance of the above indicated work <br />