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f• � � f• � ti• ii• 1♦ i♦ � � � � s tom■ ■�tt� t� tttttttttt� <br /> • CHAIN OF CUSTODY ECORD <br /> Advanced <br /> Ile <br /> { <br /> GeoEnvironmental, 1nC. Date /& Page Z of -z- <br /> 837 Shaw Road- Stockton,California- 95216 - (209) 467 1006 Fax(209) 467-1116 <br /> ClientProject Manager <br /> Tests Required <br /> rel <br /> Phone Number <br /> 207)A?---Le0fo5 <br /> Samplers (Signature) Invoice <br /> �v <br /> Project Name � AGE <br /> Client ❑ <br /> Sample Location SampWType No of <br /> Number Description Date Time Water Air Solid Conts 83618 <br /> Comp arab <br /> 83619 <br /> �'``''? �� © �t � � �t✓s� � -� ` � 83620 <br /> M60ZI// 4ii 83621 <br /> 83622 <br /> Re Ing e yIs gnatura ace ve y gnature Date ime <br /> J <br /> Reli uishe (Sig ur ) Received by (Signature) DatelTime <br /> Relinquished b (Signature) ` <br /> 4 y t g 1 Received by Mobile Laboratory for Held enalysla (signature) Daterfrme <br /> Dispatched by (signature) DatatTime a e ve for Laborato y r� D teffimo <br /> �!•�-' -���G�C=ate ��T a/ �Ll�c-�.� <br /> Method of Shipment Laboratory Name <br /> �. - e� e pn L <br /> Special lnatrucllons 4 hereby a orize the performance of the above indicated work <br /> AoA <br /> �p� i <br />