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(�- Advanced CHAIN PF CUSTODY RECORD <br /> -_ GeoEnvirontnental, Inc. Dale ps ►� p t Page _ <br /> 837 Shaw Road -Stockton. California-85215 - (208) 467.1006 - Fax (209)467-1116 <br /> Client P et Mane,, <br /> Tests Required <br /> Phone Number <br /> Sam lers: (Signature) ' Invoice: <br /> 1 � <br /> Project Name / �FC� ( � - ---------- .�� f:—�_. l' / �� AGE <br /> L <br /> lJ / Client <br /> - Sample Type %/ -------- • <br /> Sample t ocatlon Date lime _ NO °( Notes <br /> Number Description _Water Solid / / <br /> comp Onb. Air COrits. <br /> Z. ea> _- <br /> -liaTinqu y: i n urs) ace v•a y gna urs <br /> sh d bt <br /> al n u <br /> q Y' g 1— J Received by: (Signature) Date(T • <br /> r <br /> RaTinquishe y: Signalura) neceived by Mobile Laboratory for field analysis: (Signature) Det•/Tire. <br /> Ulapelchcd by: (Signalura) Dele/ Im• It•oelvaa for aboraloty by: '--- — <br /> /� Date/Time <br /> Method of Shipment: La oratory Name <br /> 6peolal Inalructiona: f 1 hereby authorlip th• perform c• of Ih• above Indlcalad work r <br />