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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> lam- GeoEnvironmental, Inc Date Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client - P��ct Manager Tests Required <br /> IZ� l <br /> Ph N tuber <br /> 7;f' -7ki 119,rs (S Katu e) Invoice <br /> AGE <br /> Project Name Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp crab Air Conts <br /> i <br /> e to is y nature Received by (SignatUFOF DatelTfine <br /> R#finquished by (Signatu e} Received by (Signature) DatelTtme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) DatelTime <br /> Dispatched by (Stgnature) Dale/Ttme Received for Laboratory by Date(Ttme <br /> Method of Shipment LaIMtOFy Ne' <br /> Special Instructions 1 hire y author a the perlormance of the above indicated work <br /> moomr— <br /> I• li i <br />