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r-g, ["7 r—T r-"-. ICT F-7 r—T r--. r-7 [-7' t� r.-T r-T f-7 r-7 T-7 7 r7"T. [—T r-7-T <br /> l <br /> Advanced CHAIN OF CUSTODY RECORD_ <br /> --- <br /> GeoEnvironmental, Inc. Date` Page of <br /> s" _ <br /> B37 Shaw Road - Stockton, California-95215-(209)467-1008- Fax (209)467-1118 r ) <br /> Client 's Project Manager Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name. 1 t / ,,� AGE <br /> tuaa;' Client ❑ <br /> Sample Location Sample Type <br /> _ No.-of-.- - <br /> --� -. Date- - :=Time== -=IIVa#tar —�-�: =Solidi - — Y - �_. - /r :,.. Notes <br /> Ntamber� - �� e � � Description comp. Grab. AIr Conts. <br /> l l 2. <br /> tie 9� <br /> ` i5 <br /> OD <br /> 13 <br /> 2 _To rn <br /> Relinquished y: gnature} ecerve y: ignature <br /> f l / / a l]ate/Time <br /> Relinquished by: (Signature) Received by: (Signature) 1 Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by:(Signature) Date/Time Received for Laboratory by: Date/Time <br /> Y 0 7 Xv.0:) <br /> ,Method of Shipment: l r� Laborato e <br /> ESpecce- re 6/- <br /> Special <br /> ial Instructions: I hereby authorize the performance of the above indicated work. <br />