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s, I• !, I• M IMI MM M r I• _M M <br /> Advanced CHAIN OF CUSTOD RECORD <br /> GeoEnvironmental Inc. Date Page of --� <br /> 937 Shaw !goad- Stockton,California- 95215- (209)467-1406 - f=ax (209)467-1118 ^9 f <br /> Client i f C Proje M age1r Tests Required <br /> P qe �it_ 7 16b �o <br /> Samplers: (Signature) �� Invoice: <br /> Project Name 42_ AGER <br /> j 1V I �G Cllent ❑ <br /> �i <br /> Sample Location Sample ype No. of <br /> Number Description Date Time Comp.Water Air Solid Conts. 'C („ Notes <br /> Grafi. <br /> c 645- yb 11 y yb <br /> C65 <br /> 1 <br /> inquis a y: (Si re Received by: (Signature) DatelTime <br /> ib-17-63 <br /> Relinquished by: (SignalumY Received by: (Signature) ' DateMme <br /> Relinquished by: (Signature) Received by Mobil*Laboratory-for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: �� Date[Time <br /> 0!=� 6�- - I <br /> Method of Shipment: CXL11) Lab-7MT,,,,k' <br /> p�f <br /> Special Instructlons: i hereby authorize the performance of the above Indicated work. <br />