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Advanced CHAIN OF CUSTODOECORD <br /> ( _ <br /> GeoEnvironmental, Inc. / Date 3-7 - Page <br /> 837 Shaw Road-Stockton California- 96216- (209)467-1006- f=ax(208)467-1118 <br /> Client �` Project Manager Tests Required <br /> � GZ�"S <br /> do � Phone Number <br /> Samplers (Signature) , �f Invoice <br /> Project Name iv4`erc�� A(3P E <br /> � t �s, ' r Client <br /> •� F � <br /> Sample Type <br /> Sample Location Date Time Water Solid No of �� / Nates <br /> Number Description comp Grab Air Cants <br /> 1 1A <br /> 0 '' - --- <br /> �Te ingtti� ig at r ece va y rgna;ure Date/Time <br /> Relinquished by (Signature) Received by (Signature) DaterTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) fj(� t]atefhmE <br /> Receivedos a <br /> Oispatched by (Signature) Osle/Tims ratory by ale/Time <br /> C i` , <br /> Method of ShipmentL y�4 Laboratory Name / <br /> GOt1UG'13�Tt'tC7fT� APPRt3PRYA'I8 !"t C ��Z�,. 1��4t <br /> Special instructions L SPAC1 hereby authorize the p rformance of the abov ndicated wo <br /> DFZHLOELINATED IN LAE pRl;86RV5D IN LABS,.......� <br /> vom arnia / <br /> ptzes>_rnvvttTtt�ta <br /> RECD SEALED &INTACT �% ----- <br />