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ro Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnviranmenW, -Inc. Date 6� Page O <br /> • of Northern California <br /> 1803 West March Lane,Suite A•Stockton,California-%207.(209)958.0254-Fax(209)865.07170 <br /> Client Project Manager <br /> Tests Fiegllired <br /> Phone dumber <br /> Samplers:(Signature) Invoice: <br /> Protect Name � t � AGE K <br /> Client ❑ <br /> Sample, Location ample Type No of r <br /> Number Description Date Time Water Air Solid Copts Notes <br /> Comp. Grab, <br /> m <br /> m <br /> N q" CJ* r <br /> N <br /> z <br /> a sn u y; gn lure eae ve "47 <br /> : nature <br /> rtelTlms <br /> z <br /> i u ehe -� tlz <br /> Y: nature -t 13 <br /> Received : f+ T " a <br /> pate e <br /> { Relinqu a by:. ip ture Received by Mobile Lab f eture) <br /> Q- -iq lb <br /> Det mms <br /> Dlapatched by: (8lgnature) atelTime" eoa ve or a oratory <br /> d Oeten•Ime <br /> Method"of Shipment: _ <br /> a ratory,Name <br /> 4.4 <br /> $pdaialr-j411otlona; „ J I hereby a_ut orize indicated the parlormenoo of the above work. <br /> did- !III "'!!q �f f�� � i.:{� p � - <br />