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M l• = m m m m <br /> Advanced <br /> CHAIN OF CUSTOD 'RECORD <br /> Ge0Envlronmental, Inc. Date��?���._�'�_ page -3 _ of�- <br /> 837 Shaw road- Stockton California- 95215- (209)467-1006 Fax (209)467 1118 <br /> Client cc�- — Project Manager <br /> D O'-Son Tests gequlrTsd <br /> z <br /> e Number <br /> ci� H b`7--k006 �0 <br /> Samplers (Signature) Invoice <br /> Protect Namee /vt��1 O : 6 `� *�..;,,.. � AGE <br /> S �_ � k, <br /> Client ❑ <br /> Sample Type <br /> Sample Location No ofc �ru <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab— <br /> ga o <br /> �h!25 X0300 J\AW `ZS 1CA301103 I bop x x <br /> e in use y ( igna re) Re–c—eWedy ignatura Oat01Ti e <br /> 10 3D r7� tSbo <br /> Relinquished by (Signature) Received by (Signature) data ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Tims <br /> Dispatched by (Signature) Date/Time Reis r Laboratary by f' pa time _ <br /> Method of Shipment Laboratory Name <br /> Spacial inatructions t hereby authorize the of The above Indicated work <br />