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f Admiced <br /> CHAIN 0- STODY RECORD <br /> GeoE <br /> - nvironmental, Inc Datta � 9 <br /> Page � of <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467 1006-Fax(209)467-1118 <br /> Client �� r7�, ���� }��L Project Manager <br /> Tests Required <br /> Phone Number <br /> 6 <br /> Samplers (Signature) qJ Invoice <br /> Project Name , ,�,(�,� � /v r AGE,[ <br /> * Client <br /> Sample Location Sample Type �u <br /> Number Description Date Time Water Solid No of <br /> Comp Grab Notes <br /> Air Con <br /> 3 i 3 . � ? Ivy`' \/ � <br /> io <br /> 1 low f � <br /> M"n <br /> 11� <br /> e^ Y ( n t e <br /> ecerve y +gnalure <br /> Rehngtushed by ( ignalure) Received by (Signature) v"'� Z <br /> Dale(Ttme <br /> Relinquished by (Signature) Received by Mobile laboratory for held <br /> Date/Time <br /> Dispalched by (Signature) DatelTrme Received for Laboratory by <br /> Date/Time <br /> Method of Shipment <br /> Labora .�^ <br /> Special instructions <br /> 1 hereby authorize the performance of the above indlcaled work <br />