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t <br /> Advanced L9 2�r' CHAIN OF CUSTODY RECORD - <br /> �� _ C?S � e �� <br /> GeoEnvironmental, Inc. °meg / page of <br /> iJ ' <br /> 837 Shaw Road Stockton, Californla- 85215- (209)487-1008- Fax(208) 487-1118 <br /> Pr act Manger Client Tests Required <br /> Phone Number <br /> Samplers: (Sign tures Invoice: <br /> AGE <br /> Project Name � L (� l Client p <br /> Sample Location <br /> Sample Type <br /> No. of <br /> Number Description Date Time Water Air Solid Conts. Notes <br /> Comp. Grab. <br /> l 0 '� 2- <br /> Z rte- <br /> f'Z- zv <br /> PZ- ZS d- <br /> -3 D (6. k <br /> P3-ro <br /> e,r btjre) eoe ve y: gnatura at Ime <br /> Tom• <,' -rA -'�- QS / <br /> eWr, uished by: (Signature} Received by; (Signature) ❑aUrTlme <br /> q <br /> Relinquished by: (Signature) Received by Mobile Laboratory for held analytic (Signature) Dele/Tln,e <br /> Dispatched by: (Signature) Datemme Received for borate Datefrime <br /> S 2 <br /> Mattrod of Shipment: boralory Nems <br /> Special Instruollonr f hereby authotize the perfor ce of ltra above Indicated worts. <br />