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CHAIN OF USTODY RECORD <br /> Advanced Date 30,y <br /> Page —L- of - <br /> GeoEnvironmental, Inc. fl <br /> r" 837 Shaw Road - Stockton California-95215- (209)467-1006 - Fax (209)467-1118 �_� <br /> Client kcLProject Manag r Tests Required <br /> � 1titic <br /> Ph )no N mtaer <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name �/' � � �` � � �/ �� � Client ❑ <br /> Sample Type No of �,� Notes <br /> Sample LOC2rhOn Date Time Water Solid (V <br /> Number Description Comp crab Air Conts �( <br />' W -612 <br /> X <br /> w X0'2- X X <br /> k� � � � Qat !Time <br /> e inquis a 195 re eceive y ignature 23 706 <br /> Date/Ti a <br /> Relinquished by (Sig lure) Received by (Signature) <br /> S- T <br /> Reimquished by (Signature) <br /> Received by Mobile Laboratory for field analysis (Signature) Dalerrime <br /> ` <br /> Date/Time Receive LaPorato Q to/Time <br /> Dispatched by (Signature) <br /> Laboratory Name <br /> Method of Shipment4�e-a <br /> of <br /> l hereby authorize the performance of the above indicated work I <br /> Special Instructions <br /> r <br />