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s <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. <br /> Date ��` '' Page �Z o4 <br /> 837 Shaw Road-Stockton,California-95215-(209)467-1006-Fax(269)467-1118 <br /> ClientC _ Project Manager <br /> Tests Required <br /> c, i"'`1. Il�r <br /> Rhone Number <br /> aO9-- ` IG'7- <br /> Samplers: ignature) ,��� invoice: <br /> / - <br /> Project Name AGE 19,�%' Client D <br /> Sample Location Sampf ype No.of -6 '� 'Z` <br /> Number Description bate Time Solid Water Air Conts. Names <br /> Comp. Grab. !�. <br /> Le,,,cA, L,n <br /> LL- I iy=� <br /> ST-Z- <br /> L <br /> He i e y: ( tonton t Received by: (Signature) Date(Time <br /> uishe y:(Signature) Received by: (Signature) patejTims <br /> Relinquished by:(Signature) Received by Mobile Laboratory for field analysis:(Signature) Data/Time <br /> GEspatched by:(Signature) Date(rime JAeceived for Laboratory by- 1 Oats/Time <br /> Method of Shipment: Labb. ry Name c,t <br /> Special Instructions; I hereby authorl a the performance of the above Indicated work. <br /> St. <br /> l - <br />