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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentaL Inc. Date Page of <br /> C425-1- 0 837 Shaw Road - Stockton, California - 95215 - (209)467-1006 - Fax (209) 467-1118 <br /> Client 61 Project Manager Tests Required <br /> 9-IV t'. I , (o: <br /> Phone Nurnb6ir <br /> Samplers: (Signature) M Irwoice: <br /> Project Name AGE <br /> Client <br /> Sample Location Sam ple Type <br /> No. of <br /> Date Time Water Notes <br /> Number Description comp era, Air Solid Conts. <br /> t4 ell L_ 1) <br /> 10 ;9 x I lid L. .Q <br /> b2- 11D it 21 5S 'X I /X LX__ <br /> net quished by*: (.1qPatu'2) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by: (Signature) Daternme <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signalurs) OetafTime <br /> Dispatched by: (Signature) Oateffirne Received for Laboratory <br /> Datafn <br /> Method of Shipment: Laborsy Hem' J <br /> Special Instructions: 1 hereby authorize the performance of the above Indicated work. <br />