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.� �. �� mss, �■ ■s, �� tttttttt� tttttttl• tttli � f• � � � I• � <br /> Advanced CHAIN OF CUSTODY"RECORD <br /> GeoEnvironmental, Inc. Date A2' Page --L of <br /> 837 Shaw Road-Stockton, California- 95215- (209) 467-1006 - Fax (209)467-1118 <br /> d 6 - ©04:�' <br /> Client �, Pr act Manager p Tests Required <br /> �s�VN.KL l�tL�b'� eq <br /> P aneumber. <br /> `��c� /-1 c~ 7 6: C1 <br /> Samplers (Signature) Invoice <br /> Project Name , AGE <br /> NPInS ALJC> Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Cants Notes <br /> Comp arab \ <br /> o'4;z K � I l v <br /> JWZA X-X X X I <br /> -ZJ3 �t�a <br /> Relinquished y gnat a ece ve y rgnature <br /> r3 aCrim <br /> Relinquished by (SLgnat e) Received by (Signature) 02 <br /> Datelr ma <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboral0 b Date/Time <br /> I - ��"I G 1- <br /> Method of Shipment aboratory Name 0 y t 0 Q--- <br /> ti <br /> �rlk5 �� CC--( �cvv <br /> Special Instructions \lE,!5-- �r I hereby authorize the performance of the above indicated work <br /> A) Ar <br />