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( Advanced 7 j CHAINS F� CUSTODY RECORD <br /> --- GeoEnvironmental, Inc. <br /> b Date ` Page L of <br /> 837 Shaw Road-Stockton, California-95215- (209) 467-1006- Fax (209)467-1118 <br /> Client A Project Manager Tests Required <br /> I i 1; c C- � <br /> Phone,Number <br /> Samplers: (Signature) Invoice: <br /> y _ <br /> Project NameAG E <br /> p��?� ) ) SU6�' <br /> y� Client ❑ <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Water Air Solid Conts. Notes <br /> Comp. Grab. <br /> — 6477 <br /> 4'" Q!a: 'b4 <br /> Ih a inquis y: ( i nature Received y: �►e te/Time. r <br /> �f r#7— <br /> 4&q,nished b nature Receive . ( a ure} atelTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Data/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Labaratofy Name <br /> Special Instructions: \ I hereby authorize the performance of the above ! icate work. <br />