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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 2-11-03 Page 2 of -- <br /> 837 Shaw Road-Stockton, California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client (fir Project Manager <br /> P"ter D04sr I Tests Required <br /> Phone Number <br /> Samplers (Signature) y Invoice <br /> Protect Name , AGE , <br /> lU 04 4r Client ❑ <br /> Sample Location Date Time <br /> Number Description Sarif Water( Ype Solid No of �R� .`� � ti Notes <br /> comp Grab Air Conts <br /> "-�1614 41')tam 1130 <br /> WLC- azo 7p 22� <br /> )�0.1 <br /> \Yl- q <br /> e in uie y Vzr '�Receivedy gnalure D te/Tim <br /> Rahn uis ed by (Signatueoll Received by (Signature) <br /> DateJTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time —Twe--.11-71or Laboratory by Date►Time <br /> iZ 2 ) <br /> Method of Shipment Laboratory Name <br /> Special Instructions I hereby auth riz the p formance of the above indicated work <br />