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L Advanced CHAIN OF CUSTODY RECO <br /> RC <br /> GeoEnvironmental Inc. Date— 9 i 3 Page <br /> of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client <br /> Project LManager ' Tests Required <br /> ►►�7 �. <br /> Phone Number <br /> Zo5 L fv - l00 �e , <br /> Samplers: (Signature) Inv ice: <br /> Project Name -Ti _ <br /> Client <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No. of Notes <br /> Comp. (arab. J41r Conts. <br /> SPS- 1 5r3ciCp)le 43 <br /> S 2-Z3 ', <br /> I 3 `3c X 7CX X <br /> SPS ) c --5 <br /> e nq +s e y ( ignature) eceive y; +gnature <br /> oat r <br /> Relinquished by: ign re) Received b <br /> y: (Signature) <br /> Data/Time <br /> Relinquished by: (Signature) Received by Mobile.Laboratory for field analysis:(Signature) <br /> Date/Time <br /> y b <br /> Dispatched by: (Signature) Date(Time ReceivedJorJaborator y R Date/Time <br /> Method of Shipment: ---------------------- rC Clv Laboratory Name <br /> Special Instructions: IfF D I f <br /> +y <br /> 7111AIIN I hereby authorize the perto ance of the above indicated work. <br /> HEAD SPACE ABSENT <br /> (�U�fe,R �c:►P_vecl Sec. ainlocl <br />