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M = r• r• MM M � <br /> s <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironrnental, Inc. Date !3" J� Page C Of <br /> of Northern Colrfonna <br /> 1803 West March Lane,Suite A Stockton,California-95207-(209)956-0264-Fax(209)956-0700 <br /> Client �+� � ,�}� Protect Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> AGE <br /> Protect Name � C' <br /> S T,,,-4-. �--�r Client V <br /> ��-U• Sample Type V <br /> Sample Location Solid No of <br /> Date Time Water �( Notes <br /> Number Description qtr Conts �Q7 � � '`� <br /> Comp Grab I" <br /> 1 �- 1 <br /> 20 <br /> E <br /> J ; 53390�� __�.; <br /> Fi <br /> a_ -gyp c t L+o !I' `,� �( � r`' �5 •i✓,,. --� <br /> l <br /> 1 y i % <br /> - <br /> e inqui y ( igneWreece-7 <br /> nature uareltrme <br /> z �GS ` Z `, Z. l <br /> MeMs by (Signa pre) Receive fltore) y <br /> Dale/Time7 7 <br /> hnquished By (Signature) Receiv d-byK_obite Laboratory for field analysis (Signature) Date/Tome <br /> Dispatched by (Signature) DatelTrme Recoived for Laboratory by Date/Time <br /> Method of Shipment C9Ltory Na s <br /> S { <br /> Special Insttuctrons �, Ers r wy vni I hereby authorize the porformance of the ove indicated work <br /> ,a -4 -At .' c.L—L_ <br /> 1 r D SPACF ABSENT'~ <br />