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' � � � r � � � � � � 1, � l• � ta■� tam � � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> � Z� <br /> GeoEnvironmental, Inc. Date Page —[— ot� <br /> J 837 Shaw Road - Stockton, California- 95215- (209)467 1006 Fax (209) 467-1118 <br /> Client Project Mana er Tests Required <br /> "A-5(� (/�'("� .� �' � . Py one umber <br /> lers {Signatu Invoice <br /> AGE <br /> Project Name ~ 1 Client <br /> Sample Location Solid Sample Type No of Notes <br /> Number Description Date Time (Nater Air Conts � <br /> Comp Grab <br /> e in ws e y re) Receivey +gnalure Date[Tigne <br /> AZI <br /> Rel fished by (Signature) Received by (Signature) Data(Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelT+me <br /> Method of Shipment Laborator a e <br /> g�ELWeJVJ%JC t�uo <br /> Special instructions r -� � 1 I here authotixe the performance bhe ove Indicated work <br /> i <br />