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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc ��y�� Date &z5,!6 z. Page t of 7 <br /> 837 Shaw Road -Stockton, California - 95215 - (209)467-1006- Fax t209)467-1118 <br /> Client Project Manager <br /> Sic�f ic,+t/ v 4,7-7"C.f Tests Required <br /> Phone Number <br /> 2os� '✓6 7 -/vU Co o <br /> G DTv cv77 -7 Samplers (Signature) v� Invoice <br /> Project Name �. ,�" <br /> AGE <br /> R—.q`�it/C� /l ��D Cliento <br /> Sample Location Sample Type <br /> Number Description Date Time Comp Water Air Solid No <br /> � n� �J �k, Notes <br /> Grab <br /> rN GY�Zro J'2o7 � 3 <br /> yl w tJG n_ 13 0-7 / <br /> YC.J / z ao -3 <br /> 2 3 <br /> e tnqu y ( ignaturey Keceivea by tgnature Date(Time <br /> RelAqvViTed b ( n re Received by (Signature) � >}ate(Time <br /> / r <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) DatelTime <br /> Dispatched by (Signature) Date(Ttme Rece v for Laboratory D te(Time <br /> Method of Shipment }� = Lab slot ame <br /> Special Instructions l isereby aut rtze the performance of the above indicated work <br /> + r F <br /> ,It ✓ GC/, <br />