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Advanced CHAP OF CUSTODY RE=CORD <br /> GeoEnvi�ronmental, Inc. Date <br /> :••..°•-.-�r•.y-•.- Page of <br /> ok <br /> 4005 North Wilson Way-Stockton,Califomia-95205-(209)467-1006-Fax(209)467-1118 r _ <br /> Client _ ��G <br /> - � Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name , Q r AGE Ey <br /> Client <br /> Sample Location Sample Type <br /> Date Time NO °t <br /> Number Description Notes <br /> Com .Water Solid Grab. Air Conts. , <br /> P <br /> l " 02477 <br /> fig 1.—7_'e> <br /> 0247$ <br /> 02479 <br /> /17, 02480 <br /> fF33- 11:5 ily 024$ 1' <br /> 02402 <br /> e rnq is a y: gnat aces a y: :gnature 22'f 0 <br /> P1r 7?f <br /> • Lac Q� 1� <br /> Relinquished by: (Signature) ed by: (Signature) f / Date/Time <br /> Relinquished by: (Signature) Recelved by Mobile Laboratory for field analysis: (Signature) DatelTime <br /> Dispatched by: (Signature) Date/Time Recelved for Laboratory by: Date/Time <br /> Method of Shipment: r Laboratory Name <br /> Special In nsWAL UINNI hereby authorize the performance of the above Indicated work. <br /> PRESERVATION t <br /> HEAD SPACE ASSENT CONTAXFRI_,e� <br />