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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvlronmental, Inc. Date _ Page zZ of <br /> 837 Shaw Road - Stockton, California 95215 - (209)467-1006- f=ax (209) 467-1118 <br /> Client �U}C, P Project Manager <br /> Tests Required <br /> t <br /> Phone Number <br /> to 0 <br /> Samplers (Signature) Invoice <br /> Project Name r 4 AGS RL <br /> Client <br /> Sample Location pate Time Sample Type No of <br /> Number Description Water Solid Notes <br /> Comp flrab hr contS ` r <br /> )N.161, � �� Z4 ? x x X <br /> (044 p j 141 G41 <br /> t <br /> as e y natu► Hecelved by ignature Datefrtme <br /> Jail/1,730 <br /> hnqurshed by (Signature) Received by (Signature) <br /> aielTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) �. � Datef ime <br /> Dispatched by (Signature) Date/Time kRcerved for borstory by <br /> Method of Shipment ., a r Laboratory Name r <br /> &J dem S 1 <br /> Special Instructions I hereby aut oriz tha performance of the above Indicated work <br /> J (� <br />