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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road Stockton, California - 95215 - (209) 467-1006- Fax (209)467-1118 <br /> U <br /> Client AProject Manager <br /> C Tests Required <br /> Ppone NunVrr <br /> 7 C ci f <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE,- J <br /> Client <br /> Sample Location Sample Type No. of <br /> Date Time Water Solid Notes <br /> Number Description Air Conts. <br /> Comp. Grab. <br /> \AW <br /> uis lgnature) Received by 7ignature) Date/Time <br /> Relinquished b.y'-'-(Sl'g nature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date[Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> MethodLaboratoryNpme <br /> of Shipment: <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />