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Advanced CHAIN OF CUSTODY RECORD <br /> Ce©Environmenir 1, Inc. Date r Z- Faye o <br /> 837 Shaw Road-Stockton,California-55295-(209)467-1000-Fax[209}467-5198 <br /> A## Project Manager <br /> Client yF tum ■�I✓ sTrze T irec! <br /> i 1 kr—r Phone Number / <br /> ti <br /> Samplers:(Signature) ► �' Invoice: <br /> Project �f 1 AGEect Name �' � {� E` <br /> Client ; <br /> Sample Location Sample Type No-of <br /> Number Description Date Time Water Air Solid dotes <br /> Comp. Grab. <br /> 3" <br /> i <br /> t _ <br /> t g q L <br /> ebnqui a y. (Signature 31 aceived y:( ignawre DatelTime <br /> Relinquished by: (Signature) Received by.(Signature) ` " 0ate/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Datelrime <br /> Dispatched by:(Signature) DatelTime Received for Laboratory by: Datefrime _ <br /> Method of Shipment: Laboratory Name <br /> (' , / it �., <br /> Special Instructions: l hereby authorize the nerformance of the above indicated work. <br /> A <br /> "rJ <br /> rx! Lot <br /> � <br />