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CHAIN OF CUSTODY ISCORD <br /> 0 Advanced <br /> - Date Page —/— of <br /> _ = GeoEnvironmental Inc. <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> IDD19 - <br /> 0 91 <br /> Client r, Project Manager Tests Required <br /> Phone Number <br /> 7 <br /> j Samplers: (Signature) Invoice, <br /> AGE <br /> Project Name Client ❑ <br /> Sample Type <br /> Sample Location No. of Notes <br /> Comp. <br /> Number Description Date Time Water Air Solid Conts. <br /> Grab, i t <br /> V/ 94427 <br /> i <br /> 2 � ✓ <br /> e mqurs y:(,+gnatu Racely d by; ignature �— p�y Date/Time <br /> Relinquished by: (Signa ure) ece' ed by: (Signature) �f ( f ( Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time TIvedcefor Laboratory by: Date(Tlme <br /> Method of Shipment: Laboratory Na <br /> oa r i {/� <br /> Special Instructions: VOAS O&G METALS OTHER I hereby auth Ize IINA performance of the above indleated work. <br /> r �n f�C.(r <br /> GJ1I[],V!401T10� AP <br /> J PM`PRIMH <br /> 'i <br />