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tttti i i i i i i i i i i i i i i i i <br /> *Advanced CHAIN OF CUSTODOECOR <br /> L - <br /> -=_ GeoEnvironmental, Inc. Date kA-F? Page R. of <br /> 4005 North Wilson Way-Stockton,Caldomla-95205-(209)467-1006-Fax(249)467-1118 <br /> Client Project Manager <br /> — <br /> ' 0 ' Tests Required <br /> Phone N mber <br /> Samplers: (Signature) Invoice. <br />" Project Name AGE Er <br />' <br /> ,01 ent ❑ <br /> .. y <br /> Sample Location Sample Type Solid No of <br /> Number Description Date Time Water Air Conts <br /> {�y Comp (arab <br /> r <br /> -1A- 1145 <br /> e,nqu a e y, gnature ecewe y (Signature) S- Date/Time <br /> Relinquished by (Signature) Received by (Signature) DalelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field anaiyals (Signature) Date[Time <br /> Dispatched by (Signature) Date/Tlme Receive Tor Laboratory by Dalelfime <br /> i <br /> Method of Shipment ` T Labr ory, e <br />` /V] <br /> Special Instructions PRESERVATIONWAS O&GIMETALSI OTHER I hereky authorize 1 e performance of the above indicated work <br /> GOOD CICE11� <br /> N 1TION APPROPRIATE /0 <br /> MUD SPACE ABSIEN�— <br /> CocUit rLQciQved GON -;:• <br /> Sar�Aori d �n I�i1' <br />