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Advanced CHAIN OF CUSTODY RECORD <br /> --- „'`' GeoEnvironmental, IIIC 7� ��; Date 41APage - - of <br /> 837 Shaw Road - Stockton, California-95215 - (209)467-1006- Fax(209)467-1118 <br /> Client ` Project Manage <br /> Tests Required <br /> It <br /> P e N tuber <br /> eovj�p <br /> Samplers (Signature) ( Invoice <br /> Project Name 1 3 '' AGE <br /> C Client ❑ <br /> Sample pe 01 <br /> Simple LocationSample <br /> Time N° °f Notes <br /> Number Description Water Air Solid Cants / <br /> Comp Grob <br /> 6 t 7 xis Cot � A, �f <br /> �--wqk3 ? - <br /> -� '7e a�- <br /> e engin y 15natur Received y (Sig -e aleTime <br /> 61 173b <br /> Rei-ngtr shed by iSignalure) Received b Si <br /> Y (Signature)y atelTime <br /> Rel n,gll4shed by (Signature) Received by Mobile Laboratory for field anatysis (Signature) DatelTim <br /> C1 <br /> Dispatr lied by (3rgnature} DatalTrma Rec v �aratory y� / ele�Tir�,e <br /> Method of Shipment ECD SEALED&INTACT VALE <br /> i h+SUV,Yr 14 Q(n %tor ms <br /> r <br /> Special instruction% n f f herebyauthorize <br /> /V j) lcw <br /> v_ pe ormance the above indicated work <br /> Don Colanlrr <br /> IIN top, <br />