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( Advanced CHAIN OF CUSTODY RECORD <br /> , <br /> GeoEnvironmental, Inc. Date ` Page —(-- & <br /> ^� 637 Shaw Road- Stockton California 95215 <br /> (208) 467 1006 Fax (209) 467-1118 <br /> Client � � j� Project Manager <br /> 14 <br /> � X, Tests Required <br /> Phone Number � <br /> -- Samplers (Sionature) <br /> Invoice <br /> Protect Name •� L �'' � AGE ' <br /> Sam le Type Client E] <br /> Sample �.ocatforl p YP No of <br /> Number Dt35GfkptlOCt date rime Water Saltd Notes <br /> ,r'---- Comp Grab Air Conts <br /> KWif-;� WA 3 --- �� <br /> i� -Cq Ct - <br /> LW I1 (1 <br /> —Fl—eli qd1s elf yh ( iignature) aces ve y ipnekura GOOD CONI]ITIO - Da f1I e <br /> BEAD SPACE ABSENT CON rA1NER$ � <br /> Relin uished b i — DECIILORINATEDINLAB PRESERVl;D <br /> q y ( g nature) Received by (Signature) VUAs _ O&G I META L9 47 ti Datafre a <br /> PRESERWION <br /> Relinquished by (Signature) r^, Received by Mobile Laboratory for field analysis (Signature) ',� L� <br /> r <br /> SEAIMINTETVIA f \ r Oate/T me <br /> dispatched by (Signature) [}atelTime caw d f b�oratory by dot /rime <br /> Molhod of Shipment r Labor ory Name 1 <br /> Special Instructions I hereby authorize the perfofma ice of the above Indicated work <br />