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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page of <br />� 837 Shaw Road- Stockton, California 95215- (209)487 1006- Fax(2041)467-111[i <br /> Client Project Manager <br /> TIA >� Tests Required <br /> Phone Number <br /> q6,7 - IoZ)aq <br /> Samplers (Signature) G� Invoice <br /> (�Protect Name 1--+� �r , � ivAGE.�— <br /> Sample Location Date Time Sample Type Solid No of <br /> Number Description Water Air Conts l�Cc` Notes <br /> Comp Grab <br /> WtlJts U` lG�� j b'� t t IA <br /> quis a y ignature} <br /> Received y ignau►re DatelTima <br /> �r '9-16' 65 /7 � <br /> Rail" uished by (Signature) Received by (Signature) DatelTima <br /> Relinquished by (Srgnalure) Received by Mobile Laboratory for held analysis (Sionahi(a) Date[Time <br /> Dispatched by (Signature) Dale/Time Re r Laboratory b ` Da (Tuna <br /> Method of Shipment � Laboratory a� <br /> Speclallnstiaetlons I hereby authorize t performance of the above Indicated work <br />