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in Advanced CHAIN OF CUSTODY RECORD <br /> 1 GeoEnvironirnental, Inc. Date Page —4— ori 14 837 Shaw Road-Stockton, California-95215- (209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phone NuTber f <br /> Samplers: (Slgrifature) Invoice: <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location sample Type <br /> Number Description Date Time Water Solid No. of Notes <br /> Comp- Grab. Air Conts. <br /> Relinature) W0—Ce—,v-eT5y: (5i9nature) <br /> MVIff 11 - <br /> KetRuished by: (Signature)': <br /> Daffl/Time lY <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DalefTime <br /> Dispatched by: (Signature) <br /> DatelTime, Received for Laboratory by: Date/Time <br /> Method of Shipment: Lab.3ra17 <br /> Special Instructions: 1 hereby aut"o a the performance of the above indicated work. <br />