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Whanced &030G(6, CHAS F CUSTODY CORD <br /> GeoEnvironmental Inc <br /> oat e 3 `�' Page oi� <br /> - „ _ Ll <br /> 837 Shaw Road- Stockton, California-95215 - (209) MO-1006 Fek (209)467-1118 <br /> Client " "" Pr ' Man er <br /> Tests Re lied <br /> Vane Number <br /> Sam a (S ature) Invoice <br /> Project AGE <br /> Lal <br /> Client ❑ <br /> Sample Location Sample Type , <br /> Date Time Solid No of Notes <br /> Number Description comWate�rrab Alr Conts <br /> p <br /> 3/Y/a'Z_ <br /> OP Rr rr� ririr)- <br /> E 5 rk� <br /> 4,Jilll !J _--�-- <br /> ✓i e. tr <br /> ifIl <br /> nq s e ( ig ture Received by ,gnature ��- atelTime <br /> Relinquished by (Signature) Received by (Signature) oatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) oatelTime <br /> t 6 <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTime <br /> Method of Shipment Laboratory Kjarrie <br /> Special instructions I hereby authorize the Kerforrrighce of the above indicated work <br /> 1 <br />