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Ad � <br /> va nced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 77 Page of <br /> of Nonitem California <br /> 1803 West March Lane,Suite A-Stockton,California-95207-(209)956-0264-Fox(209)956-0700 <br /> Client C�"5 Project Manager <br /> (14 ALL Tests Required <br /> Phone Number <br /> Samplers: (Si ature) Invoice: <br /> Project Name AGE Lam' <br /> �p Client EJ <br /> Sample Location Sample Type ,►( <br /> Date Time Water Solid No. of �l Notes <br /> Number Description Air Conts. <br /> Comp. Grab. , <br /> 2�° --- 80088 <br /> .r <br /> -5 XIX <br /> l2`�� V11I 800$9 <br /> 0 7a 80090 <br /> 80091 <br /> pt3� Szb Z <br /> 12O ✓^ j ;. H 80092 <br /> Rein <br /> n uis �t �� ✓ I 1, N 80093 <br /> e�n uis y- ( ignatu a y: ig ���Z�y bate/Time <br /> 1 - - � '76 �l�rl <br /> elinquished by: (Signature) eived by: (Signa re) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment- La <br /> boratory Name <br /> &AeZ �ecetilhed6e4leJ 9- <br /> Special Instructions: ti I he authorize the erformance of the above indicated work. <br /> VOA 0&G MET S OT 6 <br /> ICEDPRESERVATION <br /> —AITIM&I —Z - LX-11Y4f$.—f-� kA& <br /> GOOD C01,11ul I lul HEAD SPACE AESENT� CONTAINEKS <br />