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C1 - 13� <br /> CHAIN OF CUSTODY RECORD <br /> j t Advanced S44" 9 27 vl Page L Of— m <br /> GeoEnvironmental, Inc. ^' <br /> 637 Shaw Road-Stockton.California-95215 - (209)467-t006 - Fax (209) 467-1116 <br /> r <br /> Project Manager I Tests Required <br /> Client ( <br /> Phone NumberV� `� N <br /> Invoice: m <br /> S�piers: (Si ature) 1D <br /> AGE ° <br /> Project Name I j G Client El <br /> m <br /> Sample Type No. of Q Nates <br /> Sample Location Date Time Water Solid <br /> Number Descriptio <br /> n camp- Gish Air Corns. <br /> 40 '' l <br /> Z7 0/ X <br /> ) <br /> L �3f -�v 9 Z7vi l3 : Za ✓ r fit' <br /> 4,�_-57 <br /> 62 -10 <br /> ca ve y' rgneSwe �jT i <br /> e I e ig nelw <br /> y ,/� DaleRima <br /> 1i gtrishe y: iSi nature): Received by: (Signature) <br /> Dslefrime <br /> Ret nquished by: iSignature) Received by Mobile Laboratory for field analysis: (SigneNre) <br /> pete/Tima <br /> Received for Laboratory by: osta/Time <br /> Dispatched by: (Signalwe) <br /> Laboratory Name �— r <br /> C I� <br /> Method of Shipment; <br /> I h.,ekxv authorize the performance of the above indicated work. c <br /> Special Inslructiem: 7 � <br /> /tf{ <br />