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tttttttttt� t� i ti � i t� i i i i i i i i i i i i <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. _ Date Page --L tat -3 <br /> 837 Shaw Fload Stockton, California- 95215- (209)467-1006 - Fax(209)467-1118 <br /> Client Project Man a r Tests Required <br /> Phone umber <br /> �Il <br /> 5a ers' (Signature) Invoice <br /> 71 <br /> Project Name AGE <br /> J � Client ❑ <br /> Sample Type h <br /> Sample Location Date Time -- Solid No of <br /> Number Description Water Air Conts Notes <br /> J Comp Grab <br /> 1 .1,244 -b2- <br /> M�J d 1 o <br /> -a <br /> u) Ty rx-Q& -oz qaq <br /> 7elin. s e i nat a stew y ig re D a/Time <br /> 12 <br /> 6BL <br /> Reh quash ( nat r A 1 Receive y (S gn ture) Date/Time <br /> rik IQ .�// /-/W/A <br /> Relinquished (Signa urs) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Ttme <br /> Method of Shipment �J, � �•at t Labor Nam f <br /> Special Instructions Ft- SDSPAC'E °St;NT' Cc�17�ta w I hereby prize the p rformance of the above indicated work <br />