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( Advanced CHAIN OF CUSTODY REC RD <br /> Date I? Page of <br /> GeoEnvironmental, Inc. <br /> ~" 837 Shaw Road -Stockton, California-95215- (209)467-1006 - Fax (209)467-1118 [[�y <br /> Ghent DIP, o + t Project Manager _ ,C I Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name a p tt <br /> CASC40L �)A � CI en <br /> �+ <br /> Sample Location Date Time Sample Type Solid No of ,���.ti. ti v Notes <br /> Water <br /> Number Description comp Grab Air Conts <br /> on 40 rine) w l-l. N W-I a } B" <br /> Q -2 l a F I35 dI�4J?`�� SS e 4 <br /> TSI 1u 10 �6 , / it ie t5 F6+ XL <br /> ,n <br /> N 4 tI x <br /> N�,� o , E+asp. 9 ;�5 <br /> r, rr ii n Y <br /> it , 3r FFE 8$� �d <br /> xI <br /> 1( II I r /t <br /> e iuis e y (signature) ece ve y ignature Date/Time <br /> 1111 <br /> Relinquished b (Si lure) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Dale/Time Received for Laboratory by Date/Time <br /> Lab tory Name <br /> Method of Shipment © ! <br /> clA <br /> Special Instructions <br /> I hereby authorizfi the performance of the above indicated work <br />