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� s • <br /> { Advanced CHAIN OF CUSTODY RECORD <br /> -_- Geonvironmental, Inc.InCDate Page of <br /> 837 Shaw Road-Stockton, California-96215- (209)467-1006- Fax(209)467-1118 <br /> Client ; �' Project na r <br /> Tests Required <br /> F"h!_ 3e-f V, POone umber <br /> IY6 7 -/00 <br /> S ers (Si ure) Invoice <br /> Project Name AGE [d"" <br /> L �r`f'"'l �C_�l`(,� ► Client ❑ <br /> Sample Location Sample Type <br /> Date Time No of <br /> Number Description Water Air Solid Coats Notes <br /> Comp l3rab <br /> r Iain 41�­ -K, <br /> ,r <br /> � ATN <br /> e iq as e i nature ece vs y (Signature) <br /> ate/Time <br /> LL I <br /> ©2- <br /> Rei� quiahed by (Signature) Received by (Signature) Datal7ima <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Oate/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory b Da effime <br /> Method of Shipment aborato ameCZ � <br /> ILQ Y <br /> Special Instructions I hereby a nze the erformance of the above Indicated work <br /> I <br /> n! ra i k)o A �'., .1.r 1� { INA ON t.4 n <br />