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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Lt -'Mage Z of <br /> F" uJ Northern California <br /> 1603 West March Lane.Suite A-Stockton,California-95207-(209)9560264-Fax(209)9560700 <br /> Client R V G v r- L41 5 Project Manager C Tests Required <br /> l� eul h K�bf�e� � <br /> Phone Number / <br /> Vol ) `i5.6-026 <br /> Samplers: (Signature) 4'/ / Invoice: <br /> AGE <br /> Project Name V 6;r Gu; T5 """`r / Client ❑ <br /> i <br /> Sample Location Sample Type No. of s/,Y�" / / Notes <br /> Number Description Date Time Water Air Solid Conts. V� / <br /> p Comp. Grab. / <br /> v <br /> Ba - 5 Cl -;I I ti 1.5-3 y <br /> B5 - 2• l :39 1 X y X _ 9 <br /> 1� S � 5 1y=36 1 X IO <br /> 66 <br /> 37 - 7- <br /> 57 <br /> BZ- 5 tti •os i <br /> elingws a y: (S�g tui e—c—e ed y: ( ignalure) Date/T me ^ <br /> xy 'lac Ti. • T. 4-t i t7 ltS;k <br /> e/Time <br /> Relinquished by: (Signature) Re 0 <br /> iv d.by: (Signature) 7:6— / D&-b <br /> 1 <br /> ate/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Dispatched by: (Signature) <br /> Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Gf1,fir OVAF NI �� I ke <br /> special Instructions: I hereby authorize the performance of the above indicated work. <br />