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CtVQIIC�I� �C) 0 � CHAIN F USTODY RECORD <br /> Gate Page Of <br /> _— <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton,California-58215-(209)467-1008- x(209)467-111, <br /> Client nager Tests Requires <br /> no Nombev i <br /> Sarrl (S#gn red Invoice: <br /> AGE <br /> Project Name F f Client ❑ <br /> Sample Type <br /> Sample Location Cate Time Water Solid No.of Notes <br /> Number Description comp. Grab. Air Coats. � F <br /> e+nquis a y, (Sigaatute) Receive y: (Signature) p a/Tim <br /> Relinquished by: (Signature) Received by: (Signalure) DAY I I me. <br /> Relinquished by:(Signature) Received by Mobile Laboratory for field analysla:(Si attire) Date/Time <br /> piepalghed by;(signature) Date/Time Raceivad4or ab tory atelTi e <br /> Method of Shipmarlt: Laboratory a a <br /> Speci ructions: f 1 hereby auU*�hqiormanca o1 the above indicated work. <br />