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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> Date 't C t i Page --L-- of --Z <br /> GeoEnvironmental, Inc, <br /> 837 Shaw Road -Stockton California 95215- (209)467 1006 - Fax (209) 467-1118 '09- <br /> Client <br /> 0J -Client � �r� Project <br /> -Zu1Manager Tests Required <br /> Phone Number <br /> zc :�)4 n e) <br /> S ler (Signature) Irfvoice <br /> Project Name ^ = AGE <br /> Client ❑ <br /> Sample Location Date Time Sample Type Solid No of ]� Notes <br /> Number Description Water Air Conts <br /> Comp Grab <br /> I <br /> Vow•✓ � 'L Lt L�LJ � X i I <br /> N 13v& <br /> lu o I mmol <br /> q W3 tW7 <br /> e l is e yReceived y rgnature Date/Time <br /> L S <br /> Reiff -Dished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> r <br /> Dispatched by (Signature) Date/Time Racewed for Laboratory by DatelTime <br /> AV -1).X,==4 <br /> 9y �� <br /> Method of Shipment -Laboriii am,e.��, <br /> Special instructions rj E herob uthorize the perlormance of the above In sated work <br /> S <br />