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Advanced CHAIN O U CUSTODY RECORD <br /> (' S Pa <br /> "�- GeoEnvironmental, Inc. Date se <br /> 837 Shaw Road- Stockton, California-95215• (209)467-1006- Fax (209)467-1118 0 7 <br /> ClientProjegt ManageTfequired <br /> I <br /> Phone�'����Mrpber <br /> Samplers: (Signature) Invoice: <br /> 1y� �Q <br /> AGE <br /> //�� <br /> Project Name ` 9 A' clic, �_ �V Client <br /> fI Sample Type � <br /> Sample Location Date Time yyaSolid No. of �� P Notes <br /> Number Description Comp. Grab. Air Conts. <br /> 97- 10 0 <br /> 32- 15 151D I �� <br /> 62-20 13 z y- ?� <br /> 32 -2 5 <br /> -�.zfk✓ - ZS A <br /> mgws a y: ignature) eceive y: rgnature ate/Ti &30 <br /> mquished by: (Signature) Received by: (Signelurs) Dat ime <br /> Relinquished b (Signature) Received b Mobile Laboratory for lield analysis:(Signature) / Date/Time <br /> q Y: 9 ) Y ry Y 9 ) <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Dat7 <br /> Method of Shipment: Labol6ry Name <br /> Special Instructions: w• I her authorize th*.eerforrrpnce of th above in iceted work. <br /> vm // <br /> j Z Tr V ( (. T O Cc S <br />