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j Advanced CHAIN OF CUSTODY RECORD <br /> _ 1( 15 I <br /> GeoEnvironmental, Inc. Date Page of <br /> v 837 Shaw Road- Stockton, California-95215-(209)467-1006- Fax(209)467 1118 S 1 <br /> :tient ' Lac ProjectlMa�ger <br /> Tests aired <br /> .vi iA- <br /> Phone 'lumber ti <br /> Samplers: (Signature) q C 1 Invoice: <br /> 'rojea Namez r AGE ,� • <br /> �J I t �2aQ�. I�t�IIJ fife C '� �(.�-�/ t—t? � Client ❑ <br /> Sample <br /> i <br /> Sample Location Date Time Watery Type Solid No. of ; / /� Notes <br /> Number Description Comp. Grab. Air Corps. / <br /> c' - <br /> 3N - 422.0 <br /> S f? o / J-LL <br /> 1 <br /> e <br /> y- a Ig a eceive Y iflneture — Datorrime <br /> 'i iri r.r <br /> -C. 1 <br /> Relinquished by: (Signature) Received by (Signature) , �1 r�',y T A- � �['J�) Datefrimo <br /> Relinquished by: (Signature) Received,by Mobile Laboratory for field analysis: (Signature) f F Ya+J '�7 Date/Time <br /> Dispatched by: (Signature) Dale{Time Received for Laboratory by: Date/Time <br /> Method of Shipment: V <br /> Laboratory Name - <br /> j'� ^ //-' L <br /> Ili,rl.IKI- li �-�()�./ �l <br /> Special Instructions: I hereby euthortze the performance of the above indicated work. <br />