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� � l♦ � � ifififififir i♦ f♦ � � � � � � i a>_ � � <br /> Advanced CHAIN OF CUSTODfROECORD <br /> --- ,%' GeoEnvironmental, Inc <br /> Date l a i_0 Page z of 3 <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467-1006- l=ax(209) 467-1118 <br /> Client - �C!y C ssf ro Project Manager Tests Required <br /> T"&% Cuel <br /> Phone Number <br /> Qd q- Lf(o 7- 1006 <br /> Samplers Signature) 7 q Invoice <br /> Project Name �iAG E <br /> Client <br /> Sample Location Date Time Water Ype Solid No of N/moo Notes <br /> Number Description Comp Drab Air Conts <br /> ��ll� U l 115 <br /> w-1c9 <br /> eta► ZZs <br /> t X23 f 3s <br /> i 1 nature <br /> Received y cgnature Date rime <br /> /_-� r v-x,-03 J I <br /> ;jnqu�ishedby <br /> (Signature) Received by (Signature) Date[Time <br /> Relinquished by (Signature) Received by Mobilo Laboratory for field analysis (Signature) Dalefrime <br /> Dispatched by (Signature) DatefTime iv1d for Laboratory by Date/Time <br /> G Pfli <br /> CalMethod of Shipment L boratory Name C3�er �" <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br /> j <br />