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Advanced CHAIN OF CUSTODY RECORD <br /> --- GeoEnvironmental, Inc. Z Date Page _ of <br /> 4405 North Wilson Way-Stockton,California-95205-(249)467-1006-Fax(209)467T4118 <br /> Client '' Project Manager Tests Required <br /> 1 [ Air <br /> Pp9ne Ntimber <br /> Sam rs (Signature) Invoice <br /> Project Name Client ❑ <br /> � sustA <br /> Sample Type � <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp arab Air Costs i <br /> 16 <br /> 48031 <br /> tr �� q 48032 <br /> -00 �c WLdq6 /V <br /> 48033 <br /> �� �� ►_ 48034 <br /> all uis V.. y —VIlatu Received Sy ignatura Da /Time <br /> Relinquished by (Signature) Received by (Signature) atel-rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> � i a <br /> Dispatched by (Signature) Oa ime eceived for Laboratory by DatelTime <br /> Method of Shipment Labor t y M <br /> Special Instructions VOAS ON I METALS QTHI Rhereby a horiza rformance of the above indicated work ' <br /> Z^r2119110N <br /> 1501019r, ,; �T�) AD- P,rI,,�E <br />