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CHAIN OF CUSTODY RECORD <br /> Advanced11 Dare g' page 2- ofd <br /> GeoEnvironmental, Inc. <br /> 637 Shaw Road-Stockton, California-95215- (209) 467-1006- Fax(209)467-1118 <br /> Client PrOLAM maria r Tests Required <br /> Phone Number <br /> f� <br /> a rs. (Si nature) Invoice <br /> AGE <br /> Project Name Clientlua��JtA- w pr6i'-,eu, ke <br /> ❑ <br /> Sample Type No of <br /> Sample Locat on Data Time water solid i 76366 <br /> ' <br /> Number Description Com Grab /i11r Coats + <br /> Comp 76367 <br /> -- 76368 <br /> i <br /> I <br /> 76369 <br /> 76370 <br /> 10 r <br /> + <br /> 7 76371 i <br /> 76372 <br /> e in S e gnature <br /> Relinquished by (Signature) Received by (Signature) <br /> Reirngwshed by (Signature) Received by Mobile laboratory for field analysis (Signature) S7y y <br /> Date/Time <br /> DalelT+me Received for aboratory /_Pate[Tpno <br /> Dispatched by (Signature) - <br /> Laboratory N <br /> Method of Shipment <br /> I hereb auth rize t erformance of the above Indicated work <br /> Special Instructions <br /> 3 <br />