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CHAIN OF CUSTODY RECORD <br /> Advanced r, <br /> GeoEnvironmental, Inc Date Page <br /> ~" 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Pro Manager <br /> T Required <br /> t, <br /> P Number <br /> Sa rs (Signature) invoice <br /> AGE f5 <br /> Project Name Client ❑ <br /> Sample Type No of Sample Location Date Ttme Water Snlid Notes <br /> Number Description Comp Grab Air Conts i <br /> _ 71700 _ <br /> 71701to <br /> r <br /> g .� C 71702 <br /> Aw <br /> 71703 <br /> i <br /> e mqu s d y atureece vJ- y (Signature) Dateme <br /> Q00 <br /> DatelTime <br /> Relinquished by ( ignature) Received by (Signature) <br /> Relrnqulshed by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> r <br /> Date(Time Received for Laboratory by DatelTrme <br /> Dispatched by (Signature) I n!d� <br /> � I <br /> Laboratory m <br /> Method of Shipment <br /> I hereby authofi he par' m ce of the above indicated work <br /> Special instructions <br /> IF <br /> f'fstl(1 f 5 LL '000- <br />