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0 0 Q\9-1 - Co -z <br /> Advanced CHAIN)OF CUSTODY RECORD <br /> GeoEnvironmentai, Inc. Date Page —4 Of <br /> 837 Shaw Fload-Stockton, California-95215-(209)467-1006- Fax (209)467-1118 <br /> Client ` Pro ect Mana r Tests Required <br /> P rte Nmber <br /> VL <br /> m s (St nature) invoice <br /> Project Name AGE <br /> �-el7el L/�"dlti Client <br /> Sample Type <br /> Sample L atlon Date Time Solid No of <br /> Nu bet• Description Water Air Conts Notes <br /> Comp Grab <br /> Ll -1 1 <br /> j1 Z <br /> e in u� a tgna re ec ive y (Signature) Da /Time <br /> � m Q16�� 7// <br /> Re mquished by (Signalure Recewad by (Signature) <br /> / DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signatura) DatelTime <br /> dispatched by (Signature) DatelTime Reeewed}ar Laboratory by Date(Time <br /> Method of Shipment Lab story i4me -. <br /> t � f <br /> Special Instructions f hereby ut onxe the p larmance or the above Indicated work <br />