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� Advanced CHAIN OFCUSTODAECORD' <br /> GeoEnvironmental, Inc. Date 3 -q7 Page 2: of— i-- <br /> of Nonhern Cali omia <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 a �� <br /> Client L Project Manager <br /> ��e v t �, C�i b�� ✓� Tests Required <br /> Phone Number <br /> L;LOq ) 95- 6 -o26 ,- <br /> Samplers: (Si nature) F Invoice: <br /> �` AGE DA <br /> Project Name ���,{� {`� �� Client ❑ <br /> �0 <br /> Sample Location Sample Type No. of �( Notes <br /> Date Time Water Solid q .- _. - <br /> Number Description Comp. Grab. Ai Conts. ; a "74569. ' <br /> + MW- 1 7 <br /> 74.570 <br /> 7-- <br /> 0 EVV1 /3 - I <br /> t g� � . 74572 - <br /> t <br /> 1 �.3ti �( 2r �;_ _.- -7073- <br /> + MW-3/3 - <br /> 74573+ Mw-313 - 16 '77 1�=y� y` r <br /> 74-57.4_...-_ . <br /> + w— �— 1 -q I t Lla �{ 2 7( L _. .._. 74575.. . . <br /> e mquis a y: (si nature) Y ( igna r 3' Q _ 7 <br /> � tht'f + � I:34 5 �d u l"� 1-11-77/17 <br /> Relinquished b (Signature) R ived b Si na Date(Time <br /> q Y� ( g 1 Y� ( 9 1 <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 rime <br /> i <br /> Method of shipment: Laboratory Name <br /> p C o��f•h� k7, tiCU94 IR <br /> Special instructions: I hereby <br /> authorize the performance of the above Indicated work. <br />