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_ ,. _ �� a, w■t■fi (itititt�l t>_ i• fill• i• � i• � l• � � l• <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> I --- GeoEnvironmental, Inc, Date—2/7/4) Page <br /> of <br /> I <br /> 837 Shaw Road- Stockton, California-95215- (200) 467-1006- Fax (209) 467-1118 <br /> Client f M Project Manager Tests Rewired <br /> L <br /> Phone Number <br /> �� <br /> Samplers (Signa re) Invoice <br /> Protect Name A AGE �R <br /> 1�� d Client ❑ <br /> Sample Location SampleType <br /> Number Description Date Time Water Air Solid C s Notes <br /> Comp (arab <br /> _7.7351 <br /> r <br /> 0,4490 7019 o L 77352 <br /> w LIC, t a cam- 7733 <br /> � 9 d d d <br /> MLk-ex 916 77.354 <br /> (5; 7 000 77355 AF 77356 <br /> r <br /> �4 1A16?V-ri7 Va. 77357 <br /> Re nq e y gnatur eca y (Signature) Dat_ <br /> e shed y (SipWrey Received by (Signature) <br /> �r Dat fTime <br /> RelinquishedSi nature <br /> b y ( g 1 <br /> Received by Mobile laboratory for field analysis (Signature) Date[Time <br /> Dispatched by (Signature) DatelTlme Racefor a orator by Date/Tlme <br /> Method of Shipme Laboratory Name <br /> t°1(1&) c <br /> SpeoW lnattuetlons 4Y - I hereby thorize the performance of the above Indicated work <br />