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0 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 6-13-Q5- Page _ of_Lj_� <br /> of Northern Calrfomia <br /> 1803 West March Lane, Suite A-Stockton, California 95207 (209)956-0264-Fax(209)956-0700 <br /> Client V �, D Project Manager <br /> Tests Required <br /> Rob Kctr!�I-- <br /> Phone Number <br /> (;`.oq) q 5-6 -0;�6 <br /> Samplers (signature) v4� Invoice• s <br /> Project Name b C W;f 14� AGE [3i7 Sj ` y <br /> V 0� Client ❑ <br /> Sample Location Sample Type �� <br /> Number Description Date Time Water Air Solid Con=$f t° n a, Notes <br /> Comp Grab e~ `h <br /> PAW- -C _Q5 -I�-qy 1 �•'�� X i9S774 <br /> q%,2 <br /> `5f;77S <br /> �S677,5- <br /> :7, .r'677 J <br /> 25G7',-,0 <br /> Reinquis e y ignature oceive y (Signature <br /> _JJ Daterrime <br /> J —fig- r o c l'J 6-13'45 i4lo0 <br /> Roltnquished by (Signature) Received by (Signature) <br /> Qale/Tlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> QatelTime <br /> Dispatched by (Signature) bate/Time Rocelved}or Laboratory by <br /> DalalTims <br /> Method of Shipment Laboratory Name <br /> Special Instructions <br /> M,dwe5T 1-q�eoh4�or'raS <br /> 1 hereby authorize the performance of the above indicated work <br /> — _ V TO�r+en"t.-wai '+SSV►�� <br />