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[ Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnviron mental, Inc. Date Page _L_ of <br /> 837 Shaw Road - Stockton, California - 95215 - (209)467-1006 - fax (249) 467-1118 <br /> Client �G r Pro* ct Manager <br /> Tests Required <br /> Phone Number 4 <br /> La <o <br /> Sam ers: (Signature) L� V `'�" Invoice: <br /> Project Name / l ] �, ,� x V AGE � <br /> A/c, tip n I 'rr-e1 ���T � �.�.� L._t�. �� Client <br /> Sample Location Sample Type ---- <br /> Number Description Date Time Water Air Solid Co. of r' �� �' "W Notes <br /> Comp. (arab, L �"` <br /> �F 4 r:1 t b L�(u�� i'-y rti ( (�'I�.�,y5 (Z�."Z �°`� x �• >< -~—~ <br /> 1 L <br /> t�1 r <br /> i ATIra1V <br /> qws a y; ( ,gneture ece ve y: tgnalure gg,ApBpA�A AMM r)ateCCime <br /> DECH1A)MAT$D!HT PR VED_ <br /> elinquished by: (signature) Received by: (Signature) �. Cate(7ima <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> gate/Time <br /> Dispatched by (Signature) I)ate/Time Reca v=31 <br /> ry by: ❑afe/Time <br /> -1 -03 Il 'yb <br /> Method of Shipment: ) - Laboratory me <br /> Special instructions U i hereb uthoriz the performance of the above Indicated work. <br /> rrf C`-f r jrti <br />