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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> Date Page of <br /> GeoEnvironmental, Inc 0 <br /> IND <br /> 837 Shaw Road-Stockton, California-95215 - (209)467-1006 - Fax (209)467-1118 <br /> Project manager Tests Required <br /> Client <br /> P4 rt <br /> 9-el <br /> Phone Number <br /> Invoice: <br /> Samplers: (Signature) <br /> AGE <br /> Project Name Client El <br /> r <br /> Sample Type No. of Notes <br /> Sample Location Date Time Water Solid Conts. <br /> 1 <br /> Number Description Comp. Grab. Air <br /> L <br /> hW bCV4131 IM !z qU <br /> A- <br /> "o, <br /> I L <br /> L-i U)V-Q� W cyioQ ma� 'aa <br /> WIV <br /> h -C, e Date/Time <br /> Received Dy: vti-Ignaw,a) <br /> tiu- <br /> 1-t uC,-s� <br /> y: (5i nature elinquis a % <br /> ZI/ <br /> L Received by: (Signature) 7 14;7- <br /> Relinquished byrij Datelrime <br /> : (Si' re) <br /> qS7-- Datefrime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> 11 11 ''1 21R�!Laboratory " DatelTime <br /> Date/Time 1181ceivel iii i matory by: <br /> Dispatched by: (Signature) T <br /> Laboratory Name <br /> Method of Shipment: <br /> I hereby authorize the performance of the above indicated work. <br /> Special Instructions: J- <br />