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Advanced CHAN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date �/-?/ Page <br /> 837 Shaw Fload -Stockton, California-95215-(209)467 1006- Fax (209) 467-1119 <br /> Client Piaect Manager <br /> ���- Tests Required <br /> P one N ber <br /> Sa plers {Signature) Invoice <br /> Project Name ` AGE <br /> 'FC v� cis � (; a Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water Solid No of �� �/ Notes <br /> Number Description <br /> Comp Grab Air Conts <br /> kJ L56 L 1�� a 2b 6XI-J X. <br /> IT <br /> efinquis ( nature ec—e—N y ignature <br /> Dete/7i e <br /> Relinquished by ( gnaturey Received by (Signature) <br /> Dat tme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis ignahi(e)--- ���� Dater irne <br /> Dispatched by (Signature) Date/7ime Rec rvo abor <br /> ' Datel <br /> _ Time <br /> idalfiiod of Shipment ; L <br />� Labora'ary Name <br /> Special instructions it /r f hereby authorize the performance of the above Indicated work <br /> „ � f <br />