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.�. ■� i ntttttt� ttrtttttat� tatttttttt� � ttt�� >_. .ws �� � <br /> i � <br /> Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc Date 12 M-vo Page 2- of <br /> V 'l' <br /> 4005 North Wilson Way Stockton Califomia-95205 (209)467 1006 Fax(209)467-1118 <br /> Client Lenfor, r Project Manager <br /> Lo,,-,5s 5 � ����:e bests Required <br /> Ca I ur ei Lem <br /> Phone Number <br /> .201 -/& 7 1 bo <br /> Samplers (Signature) �-�' 4 Invoice <br /> Project Name �a dry <br /> Client ❑ <br /> Sample Location Sample T pe No of n <br /> Date Time Water Solid 4 Nates <br /> Number Description I` ^ <br /> Comp Grab {fir COntS <br /> c ine y Jaignature) eceive y ignatura <br /> L Date/Time <br /> Relin shad b Si nature 12 Aci-00//Sy(} <br /> q y { 9 ) Received by (Signature) Datef ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTtme <br /> Dispatched by (Signature) Date/Time Received for Laboratory Date/time <br /> ZZ� I 1 9 Oc <br /> Method of Shipmentaboratory Nade <br /> C�. � c�etflt � � l/ <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br />