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t Advanced <br /> CHAIN OF CUSTOD RECORD <br /> GeoEnvironmental, Inc. Date - 3 Page 1 of Z <br /> 837 Shaw Road-Stockton, California- 95215-(209)467-1006-Fax (209)487-1118 Q9, 7 <br /> Client Prod Manager J Tests Required <br /> Phone Number <br /> (- e)? ' <br /> Samplers (Signature) � � Invoice <br /> Protect Name � Client E] <br /> Sample Type � <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp crab Air Conts <br /> � � S lir RSI G <br /> +,o'l - b <br /> L14L <br /> e mquis e y ignatReceived y (Signature) ate me <br /> 3 <br /> Relinquished by (Signature) Received by (Signature) <br /> AT Date/Ti e <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analyara (Signature) DaterTrme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date(Time <br /> R I <br /> V�i 9- �G�� <br /> Method of Shipment Labor at e <br /> Special Instructions 1 hereby authorize the performance of the above indicated work <br />