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( Advanced CHAIN OF CUSTODY RE <br /> LORI <br /> GeoEnvironmental, Inc, Date 2- 23.9& page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client ProjectManager <br /> S � ' Tests Required <br /> Phone Number <br /> j <br /> '20' l <br /> Samplers: (Signature) <br /> Project Name <br /> ! tv Al' <br /> V, �t <br /> ��} v ❑ <br /> Sample Location Sample Type Client <br /> Number Description Date Time Water Solid No. of r,` Notes <br /> Comp. Grab, Air Conts. n /` <br /> 7 -A":R7r} LANK 4�Uc -7 StiR,I� I� Z}y�y 2; Z'' ASS <br /> � x <br /> `M N e <br /> L (1+ s �l1` 1Z 2;`0 z '. <br /> SPS ,I sr�c�prl� Na , V <br /> •z 3' 11 <br /> SPy �, SrdcK, �1� ltit�,y a <br /> 2 .23-5 <br /> S7ocK 5p - <br /> �� 5 _� IArvK Nu, 5 <br /> q '311u�-15 <br /> `- r•t_ t <br /> 3 . <br /> e rngws ed y: gn ure) ecewe 91 Q5 � <br /> (Signature) -� <br /> y: !a <br /> f� Date/Time <br /> Relinquished by: (Signature) Received by. (Signature) ' !np� <br /> Date/rims <br /> Relinquished by; (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date rime <br /> Dispatched by: (Signature) Date/Time Received fo Laboratory by: <br /> Date/Time <br /> Method of Shipment: 1 <br /> J r - Labors y Name <br /> Special Instructions: <br /> —•�� (`�R1/ATf/tft I hereby authorize he perLmance of the above indicated work. <br /> A Mn PAO 17r <br /> HEAD SPACE ABSENT' ruin IvC <br /> CONTAINM V <br /> c)ex etieV k In tel <br />