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t Advanced CHAIN OF CUSTODY RECORD <br /> Date -'?e0L4 Page { of <br /> J� GeoEnvtronmental, Inc. <br /> 837 Shaw Road-Stockton,California-95215- (209)467 1006 - Fax (209) 467-1118 <br /> Client ,�.� � C���' Project Manager Tests Required <br /> IZZOT5�l <br /> one umber <br /> Samplers (Signature) ���/ Invoice <br /> _ AGE V <br /> Project Name ��0\ Ok <br /> �� C(teltt <br /> Sample Type <br /> Sample Location Date Time Water solid ° ° � Notes <br /> Number Description Camp Grab Air COrlt$ <br /> I <br /> Xc I k > <br /> d I <br /> C <br /> "'Uu AAJ3 <br /> CR-Z�7 <br /> e inquis e y ( ignature) Tleceived by (Signature) Det ime <br /> Relinquished by (Signature) Received by (Signature) Dale/Time <br /> T" <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datel7ime <br /> Dispatched by (signature) Dateffirne Received for Laboratory by Date/Time <br /> 9ro 9 D <br /> Method of Shipment Laboratory Ka e <br /> Special Instructions 1 <br /> I her authorize the performance f e above indicated work <br />