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! ! ! tttttttt! ! ttttttttttt� ! tttttttttttl ! tt� t• ! ! ! ! t• ! ! ! <br /> Advanced CHAIN OF CUSTOD RECORD <br /> GeoEnvironmental, Inc. Date L - page --L4— of <br /> 837 Shaw Road Stockton, California-95215- (209) 487-1048 - 1"a- (209) 437-1 X18 -7 i <br /> Client � � f2rolact Maragai r f <br /> AJ c, Tests Required <br /> Pllor Numbsr <br /> mhlcr ;S�c��a��re) Invoice <br /> Project Name r {�' AGE <br /> Client ❑ <br /> Sample Location Sample Fypeme Notes <br /> Date Time f � � / <br /> Number Description Water SaI"d Cents �� <br /> Comp Grab ulr <br /> iL <br /> e inquis e by fDlanature) Received by ignature Date/Time <br /> Relinquished by (Si tune) Received by (Signature) DaterTime <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for Reid anahrsis (Signature) � Dater ime <br /> w � <br /> Dispatched by (Signature) Date/Tim a Aecaired for L*hor.tor1 1't Da?JtelT-,fime <br /> j J � G�', <br /> Ly <br /> Method of Shipment Laboratory Nam 11 <br /> Cal ��-1'LL J <br /> 'l- <br /> Special tnstructtons i hereby autho z the performan=y r the above lndica'ac work <br />