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...■. tit..r �� ttttl»1, ;,� ffs l� ■tom � I• � � � � I• <br /> ( Advanced CHAIN PF QUSTODY RECORD <br /> - _ l f <br /> GeoEnvironmental, Inc. Date � age � <br /> 837 Shaw Road- Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 7 2, <br /> Client Pro ana Tests Required <br /> , Qt, <br />� <br /> Prrie-Imber <br /> Sa rs (S pature) Invoice <br /> i <br /> Project Name (? AGE <br /> lient ❑ <br /> Sample Location Sample TypeWoof <br /> Number Description Date Time Water Air Solid Cants Notes <br /> Comp crab <br /> e iXqh <br /> e y gn ture Receivedy ignature Da /rrPolo, <br /> Helied by (Signature} Received by (Signature) <br /> Datelrrme <br /> Relinquished by (Signature) Received by Mobile laboratory for Heid analysis (Signature) Date[Time <br /> Dispatched by (Signature) Datelrime Received tot Laltlofatory b atelTime <br /> Method of Shipment r Laboratorye <br /> r,n <br /> 1 <br /> Specliat tnsttuctkone I hereby autho ze the pert mance of the above indicated work <br />