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• CHAIN OF CUSTODYOCORD <br /> Advanced <br /> I <br /> - GeoEnvlronmental, Inc 3 0 C Date :1-7-0 page -,;P- of <br /> 4005 Notth Wilson Way Stockton Cakfomla 95205 (209)467 1006-Fax(209)467-1118 <br /> Client Protect Manager <br /> r w.� � Tests Required � <br /> P none Number <br /> Samplers (Signature) Invoice. <br /> Project Name AGE <br /> ----- - - - - Client ❑ <br /> Sample Type <br /> Sample Location No of ✓ <br /> Number Description � []ate TimeWater_ Air Solid Coots Nates <br /> --- ------�-- - -- Comp Grab <br /> its to i 42407 <br /> I� 42408 <br /> 4,2-4065 A1 <br /> LV% � ' )0 �� - _ -Q k 42410 <br /> n�iti T <br /> Kr - ---- --- --- ` ti 42411 <br /> 3 5 42412 <br /> IA Lf ` 30 - - I 42413 <br /> e inquie aign(Signature) eae ve y ( tgnature <br /> � U01-if r rerrn <br /> 1 -1 <br /> Relinquished IFY (Signature)f Received by (Signature) 77 J Date/time <br /> I <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Daterrlme <br /> Dispatched by (Signature) j Date/Time calylLd tot Laborato Dala/71me <br /> Method of Shipment r - - V TT Lab tory Name <br /> special Instructions vUAt+ G i ttS OTHM I hereby authorize the performance of tt,e above indicated work <br /> r, f L <br /> — — — -- s <br />