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( Advanced <br /> CHAIN OF CUSTODY RECORD . <br /> GeoEnvironmental, Inc, a Dated=l�s gage <br /> : l Sl C� � 7 °] of__�__ <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project manager f/ C�tA-e-!I Tests Required <br /> Prone ber <br /> 41 `7 <br /> Sara ers: (Signature) t,� <br /> Project Name '� n invoice: <br /> C1 1/Y7� AGE <br /> Sample �-j Client ❑ <br /> P Location Sample Type <br /> f Number Description Date Time Water Air Solid Contsf <br /> comp. crab, Notes <br /> x 45100 <br /> t <br /> e mqu Mizi By. Wgna a eceive <br /> y: tgnature <br /> Felin by: nature Date/Ti e <br /> Received by: (Signature) <br /> Date !me <br /> Relinquished by: {Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> Dete/Time <br /> i?ispaiched by: {Signature) Date/Time Received for Laboratory <br /> MAT- <br /> Method of Shipment: Date/TimeA � no <br /> LLab ratory Name r/ <br /> Special Instructions: 4 <br /> I her y auth rize t error nce of the above indicated work. <br />