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• l �� CHAIN OF CUSTODY RECORD <br /> Advanced � <br /> Date�� �_ Rags --� of <br /> GeoEnvironmental, Inc <br /> r, 837 Shaw Road Stockton California 95215- 209 467-1006 - Fax 209 467-1118 <br /> Client Pia , Onager F r Tests Required <br /> L _ <br /> P ne N mber <br /> Sa R ars (S r►ature) Invoice <br /> Protect Name AGS <br /> Chest ❑ <br /> - it ed-F e— ' <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Gfab Air Conts <br /> I <br /> Y A, <br /> ICEW <br /> HEA SPACER SEN CO 4 rAr.4ERS <br /> DEC LORINAT IN LAB PR SER EDN $ <br /> WPM <br /> R <br /> -:p FMLE OT <br /> PRE ERVATIp <br /> i sat re stews y gnetnr D telTime <br /> e ingi y n- r <br /> Relinquished by (Signature) S Received by (Signature) Datefrime <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatefTime <br /> t}ispati had by (Signature) DatelTirt►e tlsceived for Laboratory by DatefTime <br /> Methoaf of Shipment _ Lebo t�o�y ala <br /> SpEChlt lnsttuCttana I hereby authorfz pe nor ante of the above indicated work , <br /> -REG'DSEALEfRTA" ) <br />