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t t t [ t t t t t t [ t t t i [ i t 1 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> - GeoEnvironmental Inc. Date= "Z�"° Page or <br /> �U <br /> l I w �� , C.�rc - <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientPro' ct Manager <br /> �oob�'aG�- U Tests Required <br /> Phone Number <br /> Z}� 44, <br /> -TSa ler Signature c �� Invoice: <br /> Project Name I t(06-o w1f, �v (�� Client <br /> Sample Type 1 i <br /> Sample Location Date Time Water Solid No. of �.!Ld/ 60880 <br /> Number Description Air Conts. <br /> Comp. Grab. <br /> '? 1� f y 60881 <br /> �Z fru 1 r --r&jV -T i2- ZZ- ?� H .60882 <br /> — 60883( <br /> qul y: gnature) RReceived y: (Signature) H <br /> 60884 <br /> R inquished y: (Signature) Received by: (Signature) <br /> 60805 <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Dispatched by: (Signature) Date/Time Received for Laborato y by: te/Time <br /> `/ 9-71;12.12- <br /> Method of Ship nt: Laboratory Name <br /> Special Instructions: I fieTB authori a the'pe formance of the above indicated work. <br />