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f f f ' f f f f r f r f f f f f C ' fi r , f <br /> Advanced CHAIN OF CUSTODY RECORD <br /> ---� GeoEnyironmental, Inc. Date o s <br /> Page 3 <br /> 837 Shaw Road Stockton, California-95215 - (209)467.1006 - Fax (209) 467-1118 'D <br /> ClientProject Manager <br /> Vv A��, Tests Required <br /> Phone Number <br /> 61 41- <br /> Samplers: (Signature) G'J Invoice: <br /> Project Name [4V � Trgtk 9 '� AGE <br /> IN`' '� Client <br /> Sample Type <br /> Sample Location Na. of <br /> Number Description Date Time Water Solid Notes <br /> Comp. Grab. Air Conts. <br /> X X <br /> t4v a <br /> P y-ts' it Ir !S' j 7.p s' I kA <br /> ehnquis a y: ( ignature) ecerve y: (Signature) Date ime <br /> Relin ished by: (Signature) Received by: (Signature) Da of ime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dateftime Received for Laboratory by: DatelTime <br /> Method of Shipment: Labe ry Name <br /> t c tt� <br /> Special instructions: I hereby authorize the performance of the above Indicated work. <br />