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Advanced CHAIN OF CUSTODY RECORD <br /> -. Date -�"� Page r ly <br /> GeoEnvironmental, Inc. <br /> s � - <br /> 837 Shaw Road-Stockton, California- 95215-(209)487-1006 - Fax (209)467-1118 -• ? �, j <br /> Client Project Manager <br /> �a Tests Required <br /> /Wf <br /> Phone Number <br /> ze�,7—(oU� <br /> Samplers: (Signature) Invoice: <br /> `n <br /> Project Name ry ✓ P� t `� / �n <br /> Type y. <br /> Sample Location Sample Date Time Solid No. q �l Nees <br /> Number Description Water Air Corns.s. t� <br /> Comp. I Grab. Ji I <br /> 9 -7 0 4J2_,jo%Ny X <br /> 53( '25 0�rs X ItG p <br /> -30 <br /> 0107- X I t <br /> 4 <br /> BL -35 �0 IX i x <br /> --yo 6`535S X I tfDiD <br /> 96-YS MY X <br /> 9b-4 2z 0 l 0 i Jt X • <br /> Relinquished y: ( r nature ecelve y: ignsture Oats/TI <br /> T y� <br /> Relinquished 6y: (Signature) Received by: (Signature) (, I t All I r Daternme <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) J Date/Time <br /> Dispatched.by: (Signature) Date/Time Received for Laboratory1y: Date/Ttme <br /> ( 11 <br /> Method ol8hipment: Leboot Neme_ <br /> la <br /> Special Instructions: I hereby authorizethe p/ar�lor�m/efne/e of the above Indicated work. <br />