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l Advanced CHAIPJ OF CUSTODY RECORD <br /> � <br /> GeoEnviron mental, Inc Date Page 2f: of <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467 1118 <br /> I A� Project Manager <br /> Client U' Manager +,i �6 kr , Tests Required <br /> LAPhone Number i <br /> Samplers (Signature) }� Invoice <br /> - AGE <br /> Project Name WAW 1'} C [cL Prop -kell4k ClientSam <br /> ❑ <br /> Sample Location Date Time Wa eple Type Solid No of r � � , Notes <br /> Number Description Comp Grab Air Cants W <br /> Gvt- <br /> 4-rty 7 i(q Alx 14 94489 <br /> i <br /> she y rgnat a ecerve y ignaiure Date/Time <br /> q-ml 100:0C) <br /> Relinquished by (Sr nature) Rec rued by (Signature) Date/Time <br /> RelingLied by (Signature) Received by Mobile Laboratory for held analysis (Signature) DatelTrme <br /> Drspaiched by (Signature) DatelTrme Recewed for Laboratory by Dale[Time <br /> Method of Shipment „1 Laboratory Name <br /> C o V't r K? 4 I 0&G METatS >`u 14 fir, f <br /> Special instructions UOV�f+oA1f51TEA 1f11' <br /> V—PREW, r MI K!N I hereby authorize the pe ormance of the above indicated work <br /> HEAL -CONDITION AFr"flO <br /> i <br />