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j Advanced CHAIN OF CUSTODY RECORD,' <br /> GeoEnvironmental, Inc. Date � 6'7 Page Of <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax (209)467-1118 <br /> ) 2 "Q �+ 7 <br /> Client K' Pr ' Manager <br /> Tests Required <br /> Phone Number <br /> S ers: (Signature U� Invoice: <br /> Project Name AGE <br /> Lj Client <br /> Sample =Description <br /> Sample Type <br /> Water Solid No. of <br /> NumberAir Conts. Notes <br /> Comp. Grab. <br /> is x <br /> �K�aa190 �s <br /> IAJ 66 <br /> Rdfi shed y: (Signature) ec a y: ignature DatelTime <br /> Re' fished by: (Signature) Received by: (Signature) Date <br /> i <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Datemme <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: _ j <br /> YDaleRima <br /> Method of Shipment: %) y--- Laborato Na <br /> Special Instructions: I he authorize the perforfnance of the above ndlcated work. <br />