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i i ! <br /> AdvancedCHAIN OF CUSTODY RECORD <br /> Date Page <br /> �--_ GeoEnvironmental, Inc <br /> 837 Shaw Road Stockton, California- 95215 - (209)467-1006 - Fax (209) 467-1118 <br /> Client rl�ew7-& ` C r Protect Manager <br /> f�S� Tests Required <br /> Phon — u bei [ - <br /> 152p?-) '72J 3s t :3 70 <br /> Samplers (Signature) Invoice <br /> Project Name AGE 0 <br /> I Stu, gLajk. Cheng <br /> Sample Type <br /> Sample Location Datta Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> I <br /> -Vwtp- VKZA <br /> qv <br /> e in u e by Aiqnature Received by ignature 1) Ye/Time <br /> It <br /> 0 (!er l <br /> Rehnquished y -((S nature) Received ► * � � Date[Ttme <br /> x`11 �UNfl1t /� S '{ 'o <br /> Reltnquished by (Signature) Receiv&1:1y-&W1aboraIory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatelTime Receaved for Laboratory by Dale/Time <br /> ! yr <br /> Method of Shipment ,c Laboratory Name <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />