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• • CHAIN O CUSTODACORD <br /> { Advanced D -_0 � <br /> _ Dane Page of <br /> --- GeoEnvironmental, Inc. <br /> B37 Shaw Road Stockton, California- 95215- (209)467-1006- Fax (209) 467-1118 <br /> Client It--sProject_ I a jn er Tests Required <br /> IF � Pone N mbe6-� 6 <br /> Sa' era- (Signatu e) Invoice: <br /> �Y) AGE } <br /> Project Name Et i 5e r ut Ce—_ Client ❑ <br /> r <br /> Sample Type <br /> Sample Location Date Time Water Solid No. of Notes <br /> Number Description Air Conts. <br /> Comp. Grab. <br /> D -v' o L x �J <br /> to <br /> Re m e i ature) ecerve y: ignature as me <br /> 6-4Q <br /> Reli quis ed by: (Signa r } Received by: (Signature) DalelTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: nature) Date/Time <br /> Dispatched by: (Signature) Date[Time Raceiv d r bor atelTlme <br /> Method of Shipment: EOF Laboratory h I/ <br /> Special Instructions: f 1 hereby S th ize t perform ce of the above indicated work. <br /> i <br /> I <br />