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Advanced CHAIN OF CUSTOD RECORD <br /> <<.•:�:�- GeoEnvif-onmental, Inc. <br /> Date 12--Z) Page —J— of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Required <br /> Phone Number Y�7 7-AW <br /> V 1 <br /> Samplers: (Signature) � � Invoice: <br /> Project Name C—�t� /rte '//C /�r.�� llff��'r ,�� AGE 'K <br /> Ghent ❑ <br /> Sample Location Sample Type ' <br /> Date Time Solid No. of <br /> Number Description Water �' A Notts , <br /> p Comp. Grab, Air ContS. ^� { <br /> 00784 ; <br /> 4-P107/r0785 <br /> - <br /> t <br /> �- Ll-- Z Y, z 0086 - <br /> 4 1 <br /> 00787 , ; <br /> Jul !f f_ - Y ' JI ( J 00788 <br /> —00789 <br /> _1 0079 <br /> JI <br /> el n�yis e may: (Sign/alyte) Rec ve y; gn lur �y ale/Time <br /> Relinquished by: (Signature) Received by Signature) Date/Tlme <br /> A��D - j <br /> � ,JRelinquished by: { ature) Received by Mobile Laboratory for field analysis: (Signature) VOLS <br /> f l ICED PR)SERVATION <br /> Dispatched by: (Signature) Dale/Timeived for Laboratory WOD J } i'KI Date/Time <br /> r, 11 1:6 <br /> av PX! HEAD SPACE ABSENT CON MINERS <br /> Method of Shipment: ( Laboratory Name <br /> L�k•-K�°�C �l �n.,rrrt✓ <br /> t1c 411t ll� <br /> Special Instructions: t hereby authorize the perforr4rice, of the above indicated work. <br /> i " <br />