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Advanced CHAIN OF CUSTODY RECORD <br /> --I _ GeoEnvironmental, Inc. Date -7 -2' Page ofd <br /> 837 Shaw Road - Stockton,California- 95215 - (209)467-1006- Fax(209)467-1118 <br /> Client � zti Project Manager Co t4 V14++ Tests Required <br /> s_ <br /> Phone Num -77 <br /> t` <br /> Samplers: (Signature) htle— Invoice: <br /> (� <br /> P, <br /> AGE <br /> b <br /> Project Name �� h�S `� �N �� Client <br /> i l Sample Type <br /> Sample Location Solid No.of �3 vNotes <br /> Gom p. Grab. <br /> Number Description Date Time Water Air Conts. <br /> V <br /> g3- S <br /> -zy } 1 zW 2- <br /> 750-250 X l tiv( r� <br /> 133-I541 <br /> B�-zo i v I <br /> I sct Vx l+ot <br /> Relinquished y: natur RecenrOG DY: rgnature Date/179 <br /> T-ua- a—M <br /> MA Relinquished by: (Signature) Received by: (Signature) C, -t r J1 ,-� Date ims <br /> Relinquished by:. (signature) Received by Mobile Laboratory for field analysis: (Signature) J r�� Daburnme <br /> Dispatched by: (signature) Date/Time fiWoonod for Laboratory by: r „ DatefTime <br /> Method of Shipment: fLaboratory *me �JVwy ► { <br /> -c <br /> I hereby authorize the performance of the above indicated work. <br /> Special Instructions: <br />