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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvlronmental, Inc. ��, - °tee Paye --- — °�-�-- <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1006 - Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phorate Number <br /> S rs (Signature) Invoice <br /> Project Namep� � - AGE 0' <br /> Gam. Y`a'k'. ' "J Lee- Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> i - - <br /> TkX <br /> �- A- l 77934L2 0.5 <br /> _ <br /> 77935 <br /> V &G f~�ET LS <br /> AS 10THER <br /> c <br /> 11000 C DITiON PRO RIA E <br /> Re Receive y (Signature) ate/Time <br /> D <br /> Relinquished by (Signal re) Received by (Signature) <br /> DatefT ma <br /> Relinquished by (Signature) Received by Mobile Laboratory for field anaiyaie (Signature) Date/Time <br /> Dispatched by (Signature) Dale/Time Received for Labofalo4 by Da e(Time <br /> l <br /> Method of Shipm4'W'to N rn <br /> Special instructions #F I hereby au o ze this performance of the above Indicated work <br /> J 'A��Ie'r7t— <br /> I I <br />