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Advanced <br /> CHAIN OF CUSTODY RECORC�`�a <br /> GeoEnvironmentaI, Inc, Date _j3 _ff Page <br /> =" v, , of Nat7hem Cuftjnrrua <br /> 1803 West March Lana, Suite A-Stockton, California 95207 (209)95f40264 Fax(209)956-0700 <br /> Client G D Protect Manager <br /> 00b mo^rt Tests Required <br /> Phone Number I <br /> ;-oq g 6'6 -N-6 .r y <br /> Samplers (Signature) r�s' Invoice <br /> Vr_ w, a <br /> Project Name ,e k C� P �;,� � Quo- �\ �u AGE ❑ <br /> ,v <br /> .4--a Client ❑ <br /> Sample Location Sample Type No of a �, <br /> Number Description Date Time Water Air Solid Conts �`'� ,� Notes <br /> Comp Grab <br /> 9 :30 _� x X x 13 763. <br /> Ply -379 t o lo+; X I X, x ,Jbi5763 <br /> 10��f� _ _ t _X X X 25,677() <br /> P [3 283 13, 9.0 X x X x - `Sf,»> I <br /> P13- H3C- 1 ,-1 : 30 j X X 251E77i, <br /> P13 - 5"{ j t 2O X X -GE773 <br /> o inquis a y ignatula oceive y , nature - TI Datefrifne <br /> �y (Si <br /> Relinquished by (Signature) Received by (Signature) <br /> Date/Tims <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> DalelTima <br /> Dispatched by (Signature) Date/11mo Received !or Laboratory by <br /> Dale/Time <br /> Method of Shipment Laboratory Name <br /> M(rd IMt ST ��GMq�ONj Q <br /> Special Instructions <br /> 1 hereby authorize <br /> authorize the performance of the above indicated work <br />