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T <br /> Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. <br /> Date Page of <br /> of Norlhent California <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 <br /> Client <br /> Z- C Project Manager Pb <br /> !Bt// 414-(ej Tests Required <br /> Phone Number <br /> Samplers: (Signature) <br /> Invoice: <br /> Project Name <br /> AGE ❑ <br /> Client <br /> Date <br /> Sample Location Sample Type <br /> Date Time No. of <br /> Number Description Water Solid <br /> Comp. r.b. <br /> Air Conts, Notes <br /> G <br /> VJkJ I, <br /> K . 60827 <br /> 60828 <br /> Vel q3i< <br /> To 60829 <br /> 60830 <br /> 9 e-TP—ri�q-u-- e 11r,F-T F <br /> �If e y; pignature) Gceive Y-. nature - <br /> LA-) 2-71% <br /> Resin by.- (Signature) <br /> Receive by: (Situne) i ,/47 F, <br /> Date/Time <br /> Relinquished by; (Signature) <br /> Received by Mobile Laboratory for field analysis: (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) Date/Time <br /> Received for Laboratory by. Dale/Time <br /> lVletho,4A0-rShiPme.nt. <br /> Laboratory Name <br /> T <br /> :S!plecial Instructions-.: (A' <br /> VVATIVE i <br /> — __ I I hereby authorize 1he performance of the above indicated work. <br /> - PRIATF <br /> C ION ArPROPROPRIATF <br />