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� Advanced <br /> CHAIN OF CUSTODAECORD <br /> GeoEnvironmental, Inc. �l e 113 Date `00/61 Page of <br /> 837 Shaw Road- Stockton,California- 95215 -(249)4137-1008 -Fax (209)487-1118 <br /> Cilent i Project Manager _ Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project NameAGE <br /> Client ❑ <br /> � - - <br /> Sample Location Sample Type No of t - 65265 <br /> Number Description Date Time Water Solid on1 <br /> Alr Cts <br /> Comp Grab 1 ----_- T_ it <br /> 4 1/ <br /> �w/o �y/d/a f ,l ;-- 65266 <br /> x( X- <br /> 65268 <br /> h <br /> _ -- 65269 <br /> Hal+n e y gnatura ace va y gnalure JIDate/Time <br /> 466 <br /> e quis ed by ( igna re)" Received by (Signature) Dete/TE <br /> � 77.4-T me <br /> elinqu shed by (Srgnalure) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signalute) Date/Time Received for aboralory b ` Date/Trme <br /> t Ali s <br /> Method of Shlp t Laborator a <br /> 1 V' u ti ,, TA1S OTHER e <br /> CA Ar-1 <br /> Special inatruc ons I h e6 authorize the performance of the above Indicated work <br /> GOOD CONDITION APPROPRIATE <br /> HEAD S CONTAIN KS 411iiill <br /> Y�- <br />