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j L Advanced CHAIN OF CUSTODY RECORD/ <br /> % GeoEnvironmental, Inc. I 0 $ Date !o Tc" Page of <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006- Fax(209) 467-1118 <br /> Client Project Manager <br /> L7JUr�l Tests Required <br /> Phone Number <br /> �! kl I Ila(IIN16 <br /> Samplers: (Si atur /�C <br /> Invoice: <br /> Project NameMew64&C/'S AG <br /> Client <br /> Sample Location Sample Type ;h <br /> Number Description Date Time Water Solid No, of �� y Notes <br /> Comp. Grab. Air ContS. \ <br /> zv -� s�tzz 3) ULD <br /> o ld' 21, x l <br /> � n <br /> e mgws ed y: ( ig cure) eceive y: ig nature <br /> ---date/Time <br /> Relinqui had by: (Signature) Received by: (Signature) C /) O 7Date/Ti 161 <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Com` �f Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Date/Time <br /> Method of ShipmInt: Lab at ry Name <br /> Special Instructions: I hereby aut ize the per a ce of [he above indicated work. <br />