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,�+� Inc,t4 Ad VGtJ'�Ced GeoU1 itA rm" � • . CHAIN OF CUSTODY RECORD <br /> wa — Date I4 page _�of <br /> ��� EnYinan�n�a P/ol�aS.d�r�a,Ff' <br /> 18115 Well March lane,Suite A.Stockton,California-9.5201-(20919%.0264 <br /> Adsi <br /> Client � Pro ec!Manager Tests Requill <br /> Phone <br /> /Number <br /> -Samplers: (Signature) - - - - - <br /> project Name ' �] <br /> Cent ❑ <br /> e �l <br /> SampoSample Typ .o! <br /> . Location � No.Number Description Date Time Water Air Solid Co.off�, / Notes <br /> e. <br /> Comp. ara <br /> A <br /> 3 " 48 3' r <br /> r• _ � 3.35- � " 731 <br /> 04 <br /> 1732 <br /> a rnq a y; 9natur eta y: ignervr Dolletre <br /> atinqu aha y: ( igna:ure Racerrad by:(Slgnatate � Qrd ! rW ' Oal+fllme <br /> Rehnqulahed by.(Signaturaii Received by Mobile Laboratory tot held analysis:(Signature) OaldTirere <br /> Dispatched by:(Signature) Cate/Time flecalvad for Lalbollellby, Baton"" <br /> Method of Shipment: La`otall Jbin <br /> Special Instructions: t5%044 1 w..ux, �, <br /> ��C1r9� I hereby authorize The par[gttnanea of the above Indicated wrottr. <br /> GI tYRa-.wa-+�Jawri•�. �--� <br /> 'r':0,nPruE ASS <br />