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r,-- rte. IMI r-1 1--1 r-1; r-1 r- r7: r-I r -1 r-1 r-, r-n r- 1 r-1 rn r— F-'+ <br /> Advanced CHAIN OF CUSTODY RECORD <br /> - � - Z�,.fur <br /> GeoEnvironmental, Inc. D 03150 r Date l Page <br /> 837 Shaw Road Stockton, California- 95215 209 467.1006 - Fax 209 467-1118 <br /> cifet %ecl Manager <br /> Tests Required <br /> hone NLm r <br /> r�- <br /> Samplers: (Signature) /; Invoice. <br /> Prosect Name -C , x �(1� tJ�� AGE <br /> / Client [] <br /> Sample Location Sample Type <br /> Date Time Solid No. of 'Notes <br /> Water }' <br /> Nilrnber Description Comp. Grafi. Atr Conts. f / / <br /> "x �U5-,6 <br /> PlAk <br /> e 'n�t ui, a (Siyn ture) ecerve y: �gnature pateJTime <br /> Relinquished by: S' nature) Received by: (signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory fol field ahalysW(Signature) DateJ7ime <br /> Dispatched by: (Signature) Date(rlmeRece oratory by r Dat Ime <br /> o gzo <br /> Methgd of Shipment: Labota'orr Name <br /> �C. 4,t�v�.� e� <br /> Special Instructions'. ra GOOUCOh[]1T � <br /> ----� I hor Vvthorize the performance of the above indicated work. <br /> HEAD SPACE ABSENT GONTAINERS <br /> I)'CHLORINATED IN LAB_ _ .PJ SERVEU IN LA I Mal. <br /> f�.-VOAS <br /> ��� pRESERVATION�� <br />