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Advanced CHAIN OF CUSTODY RECORD <br /> "17 -5 <br /> Page at <br /> GeoEn vi ron mental, Inc. Date <br /> 837 Shaw Road Stockton, California - 95215 - (209) 467-1006 - Fax (209) 467-1118 <br /> Pro4ect Manaaer <br /> Client a in r)a OL ), .1 . , Z Tests Required <br /> CLi "I NZ 'I K <br /> - -T- <br /> Ppone N mber <br /> e7 <br /> L <br /> Samplers: (Siggpourq rwoice: <br /> AGE <br /> Project Name Chent 0 <br /> Sample Loc JDate Time Sample Type Solid No. of Notes <br /> Comp G <br /> Number Description Water,at). Air Corms. ��� <br /> #, <br /> P <br /> I Zltl A I�-7�F <br /> N [�Eti I I <br /> 1187Da /Time <br /> is h�: ( I r ecelve y: (Signature) pliF1 T�J6 <br /> 0PJ4441 O <br /> Relinquished by: (Signature) Received by: (Signature) atqfTirn-p <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Tim-ii <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: y 0sta/Tim-o <br /> 12 <br /> N <br /> Method of Shjpment: Laboratory ame <br /> A <br /> Special Inaructions: D a <br /> I hy.erebauthorize the p a <br /> 0 n of 1he above li>&caled work. <br /> l <br /> E7 F:- <br />