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Advanced CHAIN OF CUSTODY RECORD p <br /> —2 03 Z Z <br /> _ Date Page <br /> of <br /> GeoEnvironmental, Inc. N <br /> - 837 Shaw Road-Stockton,Calitomia-85215-(209)4$7-1006- Fax(209`467-1118 W <br /> ClientProject Marker <br /> V i1�v 2r S,, Tests Required rn <br /> Phone Number <br /> Sarnple (Signature) , Irnroice: � <br /> AGE <br /> Project Name � o} c, client ❑II <br /> Sample Location SaqType Solid No.of ,`', �� Notes <br /> Number Description tate Time . Water Air Corns, QU <br /> r <br /> r comp. Grab. Air <br /> S <br /> X I <br /> $TK—Z Sz. Se ler <br /> ff ,/ <br /> STK`3 (,JAS a� SOL i1C IStia T n <br /> m <br /> D <br /> n <br /> n <br /> z <br /> c <br /> *nquis,,hed <br /> rat r Received y: gna(ure ' UaleJTime <br /> -Z-a3`)r, <br /> by:{Signature) Received by:(Signaluref. Usher irm <br /> Pelinquised by:(Signature) Received by Mobile Laboratory for field analysis; (Signature) DatelTime' <br /> Dispelohad by: (Slgnature) Dateftime Received for Laboratory by: DaleTTime <br /> • o 0 dw <br /> Method of tihipreenl: Laboratory H e G) <br /> C&( a uerr CA I 7eC h <br /> Spaclai InatrucHorro.� � f' �r f s r�r I hereby autttorize the performance or the above indicated work. <br />