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rr r� r r r rr rr r rr <br /> M (' Advanced CHAINF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Q�� Date r7�3 pass l of / <br /> 837 Shaw Road - Stock _ <br /> Stockton California-85215 (249)467-1000 - Fax(209)487-1118 <br /> Client Project Manager <br /> 1��, Tests Require <br /> - Ia S' n <br /> Phone Number � <br /> 453 A)e <br /> Samplers (Signature) Invoice <br /> Protect NameAqpl'�7 <br /> 1� �,/At, J AGE <br /> L 1 � , Client ❑ <br /> Sample Location Sample Type , <br /> Number Description <br /> Date Time Water Air Solid No of Conts Notes <br /> Comp Grab <br /> r <br /> Reelinquis ed by ignalura ace ve y (Signature) <br /> DalelTime <br /> sling y (Si ure) WAS e <br /> AT[OtV <br /> l)atelTime <br /> eiinCo NIAINER _,__!; Received by Mobile Laboratory for field analysis (Signature) f]alelTime <br /> SP C <br /> ,AD <br /> DECHWjMATED IN IABD.,...PR'$UVED IN <br /> Dispatched by (Signature) Date171me Rec Iv r La oratory b IeMme <br /> -^ rr <br /> Method of Shipment 4?006L.r <br /> L�,, Laboratory ams <br /> M C <br /> Special Instructions <br /> r e V m r,3 x r 41 ry lur{ A I hereby aulhorfxe the parformanoe at the above indicated work <br /> MH�� <br /> 4041-Z <br /> 0` sem- /f�1u' <br />