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{ Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Data 919-03 Page of <br /> 837 Shaw Road- Stockton, California - 95215 - (209) 467-1006 - f=ax(209)467-1148 09 <br /> ClientVael 'De- CP Project Manager <br /> - crests Required <br /> t Cue lictr <br /> Phone Number <br /> Samplers (Signature) �\ 4 ' Invoice <br /> Project NameI� p fir AGE � <br /> Pet-L i ri s S� 6L l oc-Ju client ❑ <br /> Sample Location Sample T9pe <br /> Date Time Water Sol1d No of Notes <br /> Number Description Comp Grab Air conts <br /> PAW 010/©1110 1 lz(At AlX Ix <br /> MW I C416 I 1101 lel\ A <br /> ik 0, 1 9'D3 tot ,( <br /> IOW I1L/01 )103 <br /> R!6!�by naturei Receiveil by rgnatura <br /> Date/Time <br /> (oa <br /> i ed by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Data Time <br /> Dispatched by (Signature) Date/Time Recelveif for aboratory b i Date/Time <br /> IL <br /> Method of Shipment L rotary Name <br /> Cc.. 1 TC-C-11 <br /> Special Instrucbons i fiereb out Drize the performance of the above Indicated work <br />