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i 1 1 i i i i i i ► i <br /> Advanced CHAIN OF CUSTODY RECORD <br /> -= GeoEnvironmental Inc. Date—~�' / Page — —Of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Pro nager <br /> Tests Required <br /> P on Number <br /> am : (Si nature) Invoice: <br /> Project NameAAG E U40 �C�� � Client y <br /> TTTT Sample Type �i � � <br /> Sample Location Date TimeSolid No. of Notes <br /> Number Description Water Air Conts. <br /> Comp. Grab. <br /> LoeK <br /> "7d i r7 <br /> 1 <br /> e inq is a y: (Sign lure) I fhyivvdy: (Sig re) te(Time <br /> Relinquished by: (Signature) ceived by: (Signature) ate/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time 777 boratory by: Date/Time <br /> Method of Shipment: Laboratorym-due,,--,AA-a LT- <br /> LW <br /> r <br /> Special Instructions: I hereby iuthori4e the performance of the abo indicated work. <br />