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Advanced CHAIN PF CUSTODY RECORD <br /> C, <br /> --= GeoEnvirunmental, Inc Data 1 t o 5 Page .I. of <br /> 837 Shaw R d- Stockton, California - 95215- (209) 467 1006- Fax (209)467 1119 <br /> I _ a <br /> Client Pro Manager <br /> Tests Required <br /> Rhone Nu be <br /> Samplers (Signature) �� v� / Invoice <br /> Project Name r-- , / A E 1a <br /> ULG C_kA 1 V G \ f Cll t <br /> Sample Location Sample Type <br /> Date Time No of <br /> Water Solid / Not L <br /> Number I]i3scfllaUtan cemp Grab Air Cants / / / 1 <br /> 7/k���,, 6&�, 0 <br /> ro <br /> - — <br /> �' <br /> v uL(2— <br /> `W6 f L /� z <br /> IL <br /> Ct <br /> jlA <br /> H� L <br /> It k>3Z ,k 0x0 Ai <br /> e quis e y i nater — T�ceive y 1gnature ale(T me <br /> Relinquished by (Signature) Received by (Signature) Oat ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date[Tirne <br /> Dispatched by (Signature) x Dale/Time Recery d to LAboratory by OatefTime <br /> Method of Shipment E — Labor ory N Sns <br /> ic)kA— <br /> Special instructions _ ,; t hereby authorize 114 performance of the above Indicated work <br /> T_ W.D SEALED& »TAcr VIA�� <br />