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Advanced CHAIN OF CUSTODY RECORD <br /> Dateage <br /> j* P <br /> GeoEn viron mental, Inc. <br /> 837 Shaw Road - Stockton,California -95215- (209) 467-1006 - Fax (209)467-1118 <br /> b7 <br /> ;tient I" ProoC Mana er Tests Required <br /> C� —7-7— <br /> PnN"mber <br /> 7V <br /> S (Sig Inve4ce: <br /> AGS,2 <br /> �roject �arrle <br /> WO <br /> Sample Locati,/n Sample Type Solid No. of "es <br /> Number Description Date Time W ter Air Conts, <br /> Camp. Grab. <br /> I Kj <br /> I jt3 nx <br /> ?(I X Ix iA <br /> Relinq shed by; 51gFittlOFS) cervi y:IM-11—ns—tu—reF L pat*64 ims <br /> TA T <br /> Received by: (Signature) DilefTimo <br /> Relinquished by: (519natU10) fijeri FAT <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Gate/Time <br /> Dispatched by:(Signature) Received for-Laborat 71,1 by; Dat*fTkne <br /> Method of Shipment: L*6ofatory Namt/,,— <br /> L <br /> hereby.juthorizo the p4jr1olmarlos of the above Indicated work. <br /> Special Instructions: of f. <br />