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Advanced CHAIN OF CUSTOD RECORI <br /> GeoEnvironmental, Inc <br /> Date � .�-a page �� of <br /> 837 Shaw Road -Stockton, California- 95215 - (209) 457-1006 Fax (209)467-1118 <br /> Client ��iS qtr► project Manager Tests Required <br /> �U I 1 +;5n AJ <br /> Phone Number <br /> '9�07 1&_) <br /> Samplers (Signature) Invoice <br /> Project NameA Client <br /> ACS <br /> Sample Location 5amp a Type No of <br /> Number Description Date Time Water Air Solid Conte y �� s Notes <br /> comp Grab <br /> LM C i La U5,17 7, 63iU54 Q 954) 1 A/ <br /> 055 -3 <br /> ug-' �3,zay tr D <br /> ti <br /> .firfo 4 ZZ 7 (0LI <br /> wrT za o U <br /> A Xz <br /> LC <br /> e quis a gnature ee ve yctg e I)f �� GOOD ONDTTToN APPROPRIATE / DatelTime <br /> �� Id HT AD PACE ABSENT _ CONTAINER�_V Q /5 d Y/111. a <br /> ORINATED IN LABS,.,, PRESERVED IN L DetelTl <br /> nquished by (Signature) Received by [Signature} VDAB 0&0 WTALg OTIOR <br /> me <br /> FtiFB TLvATIO <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DateJTime <br /> Dispatched by (Signature) Daterrime Received for Laboratory by Date/Time <br /> Method of Shipment Labor4fory N s <br /> G <br /> Special instruct;ons I hereby utharih the performance of t e above Indicated work <br /> _ TEG' j <br />