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(� Advanced CHAIN OF CUSTODY RECORD <br /> --- %` <br /> GeoEnviron mental, Inc. Date Page <br /> 837 Shaw.Road - Stockton, California-26215- (248)467.1006- Fax 208) 467-1119 v <br /> i3 <br /> Client Project anager <br /> Teats Requir�scf <br /> Phone Number <br /> ,v <br /> 'Sa <br /> rn ers: (Signature) <br /> Invoice: <br /> Project Name AGEZ <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water Air Solid Con sr xtrti <br /> comp. arab <br /> 83117 1 <br /> 83118 Ln <br /> Ln <br /> co <br /> N <br /> a .,L <br /> .. C Y TI l <br /> bU '�ITl�ld A I' :i 1?' <br /> C <br /> RW S <br /> Rel- q ishe V. (Si nature) eca w y: onature q <br /> t1 e(rime _ <br /> R linquished y: (Sionat e} Aeoslvad by; (Signature) f <br /> Date(Tlme <br /> Relinquished y: (Signaturefiacelwd by lfablle Laboratory for field analysis: (Sla�alurs) Dale/7ima <br /> Dispatched by: (8iynature) Delafrlme Delved for a or or by: <br /> \l JCr4 01�'h rY� pata/7ime <br /> � <br /> Method of Shipment: Laboraiary N mr <br /> 41 <br /> m <br /> too <br /> e lel laatruc+lone: . I hereby au Ix Yha perlormance of Yhs above indloatod work. N <br /> f!k <br />