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Advanced CHAIN 9F qUSTODY RECORD . <br /> GeoEnvironmental, Inc. Date �' 2� Page �— ot-�4— <br /> ` 837 Shaw Road - Stockton, California - 95215 - (209)467-1006 - Fax (209)467-1118 <br /> Client Pro'ect Manager 2 Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> AGE <br /> Project Name �'� J -'- Client16 <br /> Sample Type <br /> Sample Location Date Time Water Solid No. of Notes <br /> Number Description Comp Grab. Air Conts. <br /> �( �S mkt, S, ZS-' 136-7 <br /> io SWn <br /> 3 `l C0 60 <br /> � LDIL)ingws ed ye y: rgnature ..Date ime- <br /> -� r <br /> R linquished by: (Signature) Received by: (Signature) r Dale rime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Sfgnalure) 1 Date/Time <br /> �zcu �U U5 r � <br /> Dispatched by: (Signature) Date/Time Received for Laboratory `� Date/Time <br /> Method of Shipment: �6'�� La ora[o Name <br /> C? c) <br /> Special Instructions: I hereby authorize a performance of the above indicated work. <br />