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I ` <br /> j Advanced CHAIN 9F CUSTODY RECORD <br /> GeoEnvironmental, Inc - Date 3 a-L—� Page _ of <br /> 837 Shaw Road - Stockton California 95215 (209) 467 1006 Fax (249)467-11 i8 rC� <br /> Client /� Protect Manager <br /> 6 /�7 Te!* <br /> e! utred <br /> Phone Number <br /> Jk9l N� <br /> Samplers (Signature) Invoice <br /> Project Name �? r ) r AGE <br /> f c+7 N:— <br /> *ft-toe � Client F-1 <br /> Sample Location Sample Type <br /> No of <br /> Date Time <br /> Number Description water Air Solid Conts / Notes <br /> Camp Grab <br /> 1A,-4�-J <br /> FIJI <br /> h A <br /> e�inquis s ignaturs Received y ignature <br /> k� Date ime <br /> Rehr uished b Si nature)4 9 ' } itecewed by (Signature) Date/Time <br /> T _ - on �,'1tt$ 0 <br /> Relingw re} � ��WT9rJ for field analysis (Signature) Date/Time <br /> IWAD SPACE ABS WAME <br /> Drspalc Date/Time Received for Laboratory by Da a/Time <br /> Method of Shipment aboratory Name <br /> Special Instructions I hereby author! a the performance of the above Indicated work <br /> C o <br /> i <br />