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4- . <br /> Advanced CHAIN OF CUSTODY RECORD <br /> "- GeoEnvironmental, Inc. y-042_3-7 ` ��! Date �'�`'� Page of <br /> 837 Shaw Road- Stockton, California 95215 (209) 467-1006- Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> r c'C- <br /> Phone Number <br /> Samplers (Signature) 'kr L / Invoice <br /> Project Name _ J AGE <br /> Client ❑ <br /> Sample Location Sample Type No aF r� l t <br /> Number Description Date Time Water Solid S v Notes <br /> Comp 4rab Air Conts <br /> e lnqu s yi ature Received y ignalure Dat71C <br /> H '7 [tt <br /> Aeiinqu shed by nal a Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> i <br /> Dispatched by (Signature) DatelTime Received for)abo to by Date'Tame <br /> l dr /,� <br /> Method of Shipment Laboratory Name <br /> e, r C- l <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br />