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( Advanced CHAIN PF <br /> CUSTODY*C4RD <br /> GeoEnvironmental, Inc. Date 2h'-'h? Page ! of 1 <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 f 7 <br /> Client I� � C' <br /> Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name AGE Q/ <br /> 0&ij I Client ❑ <br /> Sample Location SamleType Number Description Date Time Water Solid No of Notes <br /> Comp Grab Air Cont$ y <br /> IV ka!g <br /> i <br /> lZ 1�0 ✓ J <br /> tinL75hid °� u <br /> - ignature c ve y =gnature _ <br /> )." <br /> Relinquished by {Signature) erved by {Sig ature) <br /> DateCtima <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date/Trma <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> Date[Time <br /> Method of Shipment Labor to y Napaf��p <br /> Special instructions VO'S i �r� ETES OTHER <br /> ! n U �� I hereby authorize th performance of the above indicated work <br /> API;OPMATE W <br /> ►� <br />