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� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> = GeoEnyironmental, Inc. Date 406[a Page —L– Of <br /> I„ 837 Shaw Road-Stockton, Catrfornia- 95215 - (209)467-1006 - Fax(209)467-1118 nn033 <br /> Client SAm k-lZbPro ect Manager Tests Required <br /> Phone Number <br /> i k, A aovocl 4 <br /> 7?7 <br /> S ) q�EoInvoice. <br /> -�— y AGI= <br /> Project Name �e k-ro 4ppt� �� Client ❑ <br /> Sample Location Date me Sample Type <br /> Time <br /> Solid No of Notes <br /> Number Description Comp Grab Air Conts ` <br /> -zv � C� � � aL g• 3 r <br /> ?1-3 <br /> D <br /> 0 <br /> a ingws y { i atur eceNe y (Signature) <br /> DatelTime ` <br /> 1 b%'66`ez. /K-,?0 <br /> Relinquished ignature) Received by (Signature) t—` 1 DatelTr e <br /> Relinquished by (Signature) Received by Mobile Laboratory for Geld analysis (Signature) Date rime <br /> Dispatched by (Signature) DaletTime Received for r t�by Dateffimq <br /> Method of Shipment Labratory Name <br /> Spacial Instfuctions i hereby aut a th a armance of he above indicated work I <br /> L <br />