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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> Date '3, 6V Page of <br /> GeoEnvironrnental, Inc. <br /> 7. <br /> a3 <br /> 837 Shaw Road-Stockton, California - 95215- (209)467-1006 - Fax (209) 467-1118 <br /> Project Manager Tests Required <br /> Client <br /> Phone Number <br /> Invoice: <br /> Samplers: (Signature) <br /> AGE <br /> Client 0 <br /> Project Name <br /> T6 <br /> Sample Location Sample Type No. of Notes <br /> Solid <br /> Date Time W er <br /> Number Description comp. Grab. Air Conts. <br /> I e catio <br /> r Lo cripti <br /> e Des <br /> X <br /> NX 'X <br /> H v�'-1- lci I b 6 '�t?6's H -5 <br /> X <br /> A, <br /> htd(D)d h sn' <br /> J <br /> 13 <br /> Ji <br /> irriw. <br /> � 6 I <br /> W—Qn­a­iu-r-*T- <br /> y <br /> Heiinquis e <br /> y� t 1V <br /> ime <br /> _k k� DaterTime <br /> Relinquish"by:14iPature) Received by: (signature) L:D&te1Ti_Me <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(signature) <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: 0"ate/Time <br /> Laboratory Name <br /> Method of Shipment: 'Al <br /> On I hereby authorize the performance of the above indicated work. <br /> Special Instructions: <br /> E,_L) J2L L LVII h L�/ Ifaf <br />