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i � � � � � � tI♦ � � � � t• � I• �� � ! ft#I� <br /> l <br /> Advanced • CHAIN OF CUSTODOKECORD <br /> GeoEnvironmental, Inc. Date 5"W `7 q 5 Page -7- of <br /> of Northern Cahfomta <br /> 1803 West March Lane Suite A-Stockton California-95207-(209)956-0264 Fax(209)956-0700 f <br /> ClientProject Manager <br /> �� V6 NYlTests Required <br /> Phone Number <br /> (�01 ) 45r;-az6L( <br /> Samplers (Signature) = Invoice <br /> Project Name �14r7�G W ��L---� Nl-U �[I I' I ��l.4frr�1. h'141 `r a AGE <br /> Client ❑ <br /> a <br /> Sample Location Date Time Sample Type Solid No of d Notes <br /> a <br /> Number Description Water <br /> Comp Grab Air Cants <br /> L <br /> V3 - 10 52697 <br /> t i <br /> ^r rt 52690 <br /> D - <br /> [0 y 1 I X <br /> 52099 K <br /> I <br /> b 52200_--_ <br /> i <br /> 52701 i <br /> r <br /> e l quis ed by <br /> R ign ure cc y r nature <br /> 7 fi �i'�d 4� DatelTime <br /> I p1 <br /> Relinquished by (Signature) Recery by (Sig alure) If��r'" �r n [� rrtf' � 1;r it!", -Date/Time <br /> `�)�� 1q f`Ef j►r / P!EpStERV1Alll�f 1IIIII <br /> Relinquished by (Signature) Received by Moble Laboratory for field analyse �i:N�+,ij' ` Date/Time <br /> 1 A sr MSENi�. � Pen�rr I <br /> i Dispatched by (Signature) Date/Time Received for Laboratory by DatelTime <br /> Method of Shipment Lab o a Dry N me <br /> /�-"� � <br /> Spectal Instructions I hereby autho ze the performance o1 he above indicated work <br />