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j Advanced CHAIN OF CUSTODY RECORD In <br /> --- r. <br /> GeoEnvironmental, Inc. Datease of <br /> 4005 Nath Wilson Way-Stockton,California-95205- 209)467-1006-Fax 209)467-1118 m <br /> I I 18FlSS' <br /> Pr <br /> Client oject M <br /> ager Tests Required <br /> n <br /> P e IN ber ° <br /> &O�, h <br /> 0 <br /> Vprs: gnatur )7 Invoice: <br /> )oject Name /`�'(Af AGE, ~ <br /> �� Gierlt ❑ <br /> Sample Location <br /> Sample Type Solid N0 Notes <br /> Date Time Water - <br /> Number Description Comp. Grab, Air C0r1is. <br /> + — � � K <br /> it y �r 1C 4 �4+ -3� 159 -- <br /> ._A-146 31160_ <br /> t 1Gl e` 31161 <br /> 61 N <br /> - 1 — <br /> t '-3-"fi2 <br /> t e- 31163 <br /> f' -# /OJO <br /> N <br /> O <br /> 5ishe <br /> V. i9n tur -Scene y: (Signature) OatelTime <br /> �, �lISI6� o ate m <br /> Slgnetu ) Received by: (Signature) Dela/7ime N <br /> m <br /> Relinquished by: (Signature) Received by Mobile laboratory for field analysis: (Signature) OatefTime "• <br /> Dispatched by: (Signature) Date/Time <br /> p Received for Laboratory by: DatafTims <br /> Method of Shipment: UCIAS DlY6 t:(c%1LS OTHER <br /> 0 <br /> Special Inetluctinn-S: �, r / `�_, .T 1 hereby authorize t performance of the above indicated work. N <br /> C1i J✓1.v1i�iTjU APR'llY Ic <br /> m <br /> CI"Q .I Gr. 0 L4 4111W— <br />