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4 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date -i )' - Page�' ,"') of <br /> lif -nia <br /> of Northern Ca <br /> ot <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209)956-0264-Fax(2D9)956-0700 <br /> Client + Project Manager Tests Required <br /> Phone Number <br /> c�- <br /> Samplers: (Signature) Invoice, <br /> Project NameAGE i�X <br /> Client <br /> 7. <br /> Sample Location Sample Type No. of r <br /> Date Time Solid Notes <br /> Number Description Water Air Cants.Comp, Grab, <br /> s,J Z 9 <br /> 2.0 <br /> x <br /> I t <br /> RSPnquished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time ceive for LaL,77�^ DatelTime <br /> C� <br /> Meth d ofShi t Lab6ratcry Name <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />