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l• 1• � � � � � � l� � � � � � �■■ �� tliii111� <br /> • <br /> ' Advanced CHAIN OF CUSTODY RECORD <br /> eo Date � Page `�, ._.._� <br /> G Environmental, Inc. of <br /> 837 Shaw Road ad Stockton, California-95215- (209) 467-1006 - Fax (209) 467-111 B <br /> Client � � Project Manager <br /> Tests Required <br /> Phone Number <br /> c <br /> Sam ` ers (Signature) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Type <br /> 5arnple Location Date Time Water Solid No at Notes <br /> Number Description Comp Grab Alr Conts t <br /> l X <br /> ICER° <br /> _ GOOD Cc NDMON- <br /> BUDS <br /> DEOIL01 jNATED E 4 LAB isRESB VE IN <br /> PR B Anom <br /> �e ingw1 gnat ace va y gnature <br /> pate(ri <br /> Relinquished by (Signature) Received by (Signature) <br /> at ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datuffime <br /> Dlspet-hed by (Signature) Datel7ima c ve or Lpboratory b DatelTime <br /> �' lJOct 1 <br /> Method of Shipment Labo tory Name <br /> J <br /> Spat al 1nsltutLlons I hereby aut or a the performance of the above Indicated work <br />