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_ n CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. <br /> Advanced C, �_� �� Date 3�tc�(v� Paye <br /> " <br /> 837 Shaw Road Stockton, California-95215-(209)467-1006 Fax(209)467-1118 <br /> Ghent c-e Project Manager Tests Required <br /> Pftom Numw <br /> Samplers ( Te) Invoice <br /> Project Name AGE <br /> Sample Type �y <br /> Sample LocationNo Time Water Solid No of / Notes <br /> Number Description Comp drab Air CDntS <br /> 1.y ! r f <br /> U 3t k1+� !l a iU�+! !2 ?jLi •l <br /> 3 <br /> a; I L33� <br /> in ups 19neture ReceiVbd by (Signaturo) Datc[Timo <br /> d3�i-•<U t 1. <br /> Relinquished by ignature) Received by (Signotura) Dalo(Timo <br /> Relinquished by (Signature) Received by Mobila laboratory for field analysis ( ) 'rte Datartime <br /> Dispatched by (Signature) Date[Trmo Rocomod for or p ata/Time <br /> rSL <br /> Method of Shipment Lsboratory We <br /> 11 _p I <br /> Special Instructions l 4r I hereby outhorixo th per t ance of tho above rndteatod work <br /> e <br />