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t Advanced CHAIN OF CUSTODYRECORD <br /> GeoEnvlronmental, ine. Dated t Page of <br /> of Northern California <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209) 956-0264-Fax(209)956-0700 <br /> Client Project Manager <br /> -VA 0 C.attic C Tests Required <br /> iIDr&-D -[c am � � Phone Number , <br /> S` ocl2 'J Samplers: (Signature) <br /> � invoice: <br /> Project Name 4 AGE ❑ <br /> l 1- t1)1v-1 "A Client ] <br /> Type ype <br /> Sample Location SampleNo. of c <br /> � <br /> Number Description Date Time Water Solid <br /> n� -s` Notes <br /> Comp. Grab. Air Conts, (� <br /> J <br /> ehnquis ed y: (Signature) Receive y: (Signature) <br /> J OatelTime <br /> Relinquished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) i Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) patelTimeReceived for Laborator by <br /> . Date/Time <br /> Method of Shipment: oratory Name <br /> Special instructions: I hereby authorize the performance of the-above indicated work. <br />