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Advanced CHAIN OF CUSTODY RCORD <br /> GeoEnvironrnent S � R <br /> -. . �` al, Inc Date� -�... _._ atf- of <br /> 837 Shaw Road Stockton,California-95215-(209)467 1008-Fax(209)467.1 118 ^� <br /> Client t <br /> / Pr Manager Tests Required <br /> Rho e Number <br /> 6-7 <br /> Samplers (Sign re) Invoice <br /> Protect Name j` �/``� / AGE <br /> cb,)�aCicero <br /> Sample Location Sample TypeNo <br /> Number Description Date Time _ Water Air Solid Conts �;' /� f / NWes <br /> Comp Grab <br /> Loi <br /> T2,C1 y ( n ra stews y ignature) <br /> atefYlm . <br /> Relinquished by (SlqfiaforoReveived by (Signature) t)atelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Dispatched by (Signature) Date/Time Fle'gw-6d for La tory by Da etTtme ,�7 <br /> Method of Shipment �,`!✓ Labor Namf 7— <br /> , <br /> r <br /> Special Instructions R, / ;n C144— 1 hereby authorize the rformanca of the above indicated workC� <br />