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Advanced OF CUSTODY RECORD <br /> j� -_ <br /> � � - <br /> GeoEnvironmental Inc. Rqq Date Page ;-7 of <br /> n ► - <br /> _11 <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1119 <br /> Client Project Manager <br /> � S Tests Required <br /> 1' <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE <br /> "*— Client Q <br /> Sample Type <br /> Sample Location No. of `S <br /> Number Description Date Time Water Solid <br /> p Comp. Grab. Air / Conts. <br /> T-2 TM-Ctl 2 <br /> 2. <br /> r. <br /> 3 <br /> s?3 /.It <br /> e i\quis a y: ( i n ece ve y: ignat re _�- DelelTime/ <br /> - - `t ! 11. <br /> R©inquished by: (Signature) Received by: (Signature) Dale/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date(Time <br /> Method of Shi ment: Ifs Laboratory Name <br /> aV� _IWO PRESE9VATION N1tC , <br /> Special Instructions: 000DGllVUlllPMPRIAIEV 000"' 1 hereby autho ize the performance of the above indicated work. <br /> HEAD SPACE ABSENT CONTAINERS <br /> /' <br /> �\ ( Aar Aft <br /> C'_ehlpP--- q.Pi tev«1 ��uc�Sa1 rtih.(t�`, <br />