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Ir <br /> Advanced CHAIN OF CUSTODY RECORD <br /> --- "� GeoEnvironmental, Inc <br /> Date 6 Page ^ of_1— <br /> 837 Shaw Road-Stockton, California-95215- (209) 467-1006- Fax(209)467-1118 <br /> Client Project Manager <br /> � Lim e Tests Required <br /> Phone Number <br /> v2) 1/-(,- <br /> Sample <br /> 6Sample s (Signature) Invoice <br /> Project Name AG4 <br /> iLil)9Z 69d& Client <br /> Sample Location SampleType No of <br /> Date TimeWater Solid u t <br /> _ � �,. <br /> Number Description Camp arab Air Conts V a z <br /> � '� <br /> fp ' <br /> k olvIl34 <br /> 1.4 <br /> e Inqu Received By gnature Date/Time <br /> eik q by ignature Received by (Signature) DaterTime <br /> -ffe inqu a e by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) DatelTime ReceI a forMabolyallorby DatetTime <br /> !1 t j/ <br /> Method of Shipment Laboratory game U 't <br /> (!dLC- C'Y't L <br /> Special Instructions Frrtf� PPEFp1r�Tl!lN ' '' ' if 6t by aut lze the performance of the above Indicated work <br /> ,i fi � 1i.rl t f't„"I�ih <br />