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Advanced �� )Z CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentai, Inc. Date r -95 Page of - <br /> �" of Norrhenr Califonzia <br /> 1803 West March Lane, Suite A-Stockton, California•95207-(209)956-0264-Fax(209)956-0700 <br /> Client } Project Manager <br /> to 01. ' r l Tests Required <br /> j ; Phone Number Y <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE ❑ <br /> Client <br /> Sample Location Sample Type I` <br /> Date Time Water Air Solid No.t$f 1 5 5 9 31 <br /> Number DescriptionI <br /> Comp. Grab. r t <br /> qa <br /> r <br /> ;;717 <br /> r <br /> ' 55a�0 <br /> esin,quishe -by: (Signature) e-ceive y: ignature pale/Time <br /> Relinquished by: (Signa we Receive y: (Sig ure) Date/Time <br /> Relinquished b — f � <br /> q y: (Signature) Received by Mobile Laboratory for field analysis: (Signature) f C59 �q * � <br /> p :1 a `F 1 i <br /> Dispatched by: (Signature) Date/Time Flecnived lot Laboratory Y=b A rr <br /> 1� <br /> f � <br /> Method of Shipment: Laboratory Name <br /> IVL <br /> Special lnsuuctions I hereby aut on a the performance of the above indicated work. <br /> ^'r* PIiECLrl ATI L_ _ _ <br />