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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. (�- (os—i Date t() v,CZ- Page J of <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006 - Fax(209)467-1118 <br /> Project Mana <br /> Client g <br /> FAR u '-5 Tests Required <br /> 14"L- <br /> Phone <br /> Phone Number <br /> Samplers: (Signature) L �q Invoice: <br /> b (f ct <br /> Project Name AGE <br /> G� /_�r� v ��r <br /> ` �� Client <br /> Sample Location Date Time Sample Type Solid No. of Li Notes <br /> Number DescriptionWater Air Conts. C <br /> Comp. Grab. <br /> (Soo7v.. 11�7 <br /> 20kocp <br /> 140L <br /> S'�S® �� f •Z��' k � luL � <br /> PIS--2o 4 oz(7 <br /> Re - - C c s <br /> 40 <br /> e mgws a y: (Sign atur ) ecerve y: ignature (U C Tat e l <br /> Relinquished by: (Sign ure) Received by: (Signature) Date/Time / <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Data/Time Received for Laboratory by:„ ) Date/Time <br /> /O— -`2 <br /> Method of Shipment: ✓ ebotafory ame <br /> (fW46ff/ l/' (- <br /> Special Instructions: I hereby authorize the F forntafice of the above indicated work. <br />