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tftttti� �w i_ e, �i■■r � � � � � � � � � � � � <br /> ( Advanced CHAIN PF CUSTODY RECORD <br /> GeoEnvzronmental, Inc. y(a Date e Paye -L--- of-�L--- <br /> 837 Shaw Road -Stockton, California- 95215-(209) 467-1006 - Fax (26A 467-1118 <br /> Client PpAocLManaMr Tests Required <br /> Phone Number <br /> itz lamp <br /> Sam (Sf ure) <br /> Invoice <br /> Project Name AGE gL <br /> ,S-/ `, Client ❑ <br /> Sample Location Date Time Sample Type <br /> Number Description Water Air Solid ! Notes <br /> Comp Grab <br /> cYi�al Conts <br /> 65629 <br /> 4 <br /> 65630 <br /> k i <br /> I <br /> F) s e gn re ts/Time <br /> ehnquished by (Signature) Received by (Signature) Date Ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for fieid analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date(Time <br /> yan Cin C 10AJ- 1411-7/01 rr 3d af7-1- <br /> Method of Shipment Laboratory Name <br /> Special instructions a ''"`J"TION , ' I hereby aut r the pe manes of the above indicated work <br /> G609 Tim Pf<ESt:,ti r, <br /> HEAD SPACE ABSENT CONTAINERS L/ �� �'r S'rctb4 <br /> � <br />