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CHAIN OF CUS <br /> TODY RECORD <br /> Advanced <br /> _-= GeoEnvironmental, Inc. Date 7 p Page I <br /> 837 Shaw Road Stockton,California-95215-(209)467-1006-Fax(209)467-1118 <br /> ClientProject Manager <br /> pt '� —L)W lC-kL Tests Required <br /> Phone Num <br /> Samplers (Signature) Invoice <br /> Project Name �(I AGE <br /> %-U� L�� Q` Client ❑ <br /> Sample Type <br /> Sample Location No of Q <br /> Number Description Date Time Water Air Solid Corrts t11 Notes <br /> Comp (arab <br /> CPT_ 1 54, C.F- I sir J". 5 l 7/2/05 OU-0 <br /> CPT-1 12! CF—1 - t 6q -{v `(z alqgg <br /> Cf=1 lai + <br /> -Relinquished y {Signature) eoe ve y (Signature) D te/Tr e <br /> T 20 0 3� <br /> Relinquished by (S�gnature) Received by (Signature) 'Datetrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) J ' ' t T- DatelTlme <br /> Dispatched by (Signature) Dateffima Received f bomtoryby. ros tefTlme <br /> n,�,/,,A 1 171-24 <br /> Method of Shipment /) f tf�7 � � 6,0 1 Laboratory N <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />