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r• �� l� Ill• l� Illllllllllr .� lllll♦ -� � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page <br /> -- of <br /> of Northent Califonda <6o <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 <br /> Client Project Manager <br /> F1 e �' CuGI In P. <br /> Tests Required <br /> Phone Number <br /> 20 C1-- zJ 1a-OZ <br /> Samplers: (Signature) Invoice: <br /> AG E <br /> Project Name tn <br /> Client ❑ <br /> F14C, C j4,1 Gf��vro rl <br /> Sample Location Sample Type No. of '1� <br /> Number Description Date Time Water Solid Notes <br /> p Comp. Grab. Air Conts. - <br /> r <br /> 6�,gss <br /> N.. ...5Q50.a._ ..- <br /> fs--L rj 2-9- r 80503 <br /> �\ r� <br /> P2:>-30 <br /> 80504 <br /> r� IV <br /> it <br /> 80.50 7 r <br /> e inquis a y: ( ignature eceiv y: i nature DatelTime <br /> AM A 6.0-0 <br /> Re' qufsh yf Vignature) Rec 'ved ( ' nature! Da !Time <br /> //OD <br /> Re rnquished by: (Signature) Re i ed by Mobile Laboratory for field analysis:(Signature) ale/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: 0 5 O s <br /> r , <br /> Method of Shipment: 60D qf- aboratory Name <br /> Special Instructions: I hereby authorize the performance of the above Indicated work. <br /> VOAS 4&G TLS ER <br /> GOOD CONDITIOiV APPROPRIATE /1 <br /> HEAD SPACE ABSENT CONTAINERS <br />