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Advanced CHAIN OF CUSTODAECORD <br /> I <br /> GeoEnvironmental, Inc Date Z-z 1-,� Page �_ of� <br /> 4005 North Wilson Way-Stockton,California-95205 (209)467 1006 Fax 1209)467 1118 1 <br /> Client RATAWA-TF-91W S Project Manager �_ � <br /> Tests Required <br /> v L <br /> Phone Number <br /> if <br /> Samplers (Signature) Invoice { <br /> Project Name r /1 / r AGE <br /> ta— <br /> Clientz <br /> � <br /> Sample Location Sample Type , <br /> � Number Description <br /> Date Tlme Water Solid N° °f Notes 1 <br /> Comp Grab Air ContS <br /> )r a 4t� Gpr barin� No - o !Lj�1 req 3 v4A � / j� �j��f� f { <br /> f Q ! Crw T I! bG 4+$2 / I'L eGt'1 t+-ei 1T Ik tT <br /> 5� 'IQ . 1 I 1 1 c6 7a 2 F- <br /> ► Pia /o$ `°!/1 ' r ' elogr"/IIF X � <br /> i <br /> Relinquished y { ignaturejReceived y (Signature) <br /> [Time <br /> �T� Date <br /> felinqufshed by (Signature) Received b ^0 D 3 3D 1 <br /> t y (Signature) <br /> F Data/Time <br /> I <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Dale/Time ReIved fo Laboratory by ft Daterrime <br /> a 093,0 1 <br /> + � <br /> Method of Shipment La oratory Name <br /> �'9 G C � AGI ,C�J <br /> Special Instructions 1 hereby authorize the performance of the alio a indicated work <br /> 6� M r t A �fl 2- PC. E � F � � S � <br />