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[ Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. -c,�©c�. Date Page --1- of <br /> Capt � 1���, <br /> 837 Shaw Road - Stockton, California-,95215 - (209) 467 1006 Fax (2 )467-1116 <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> -owl 6;��Aa.. I W(4 <br /> §aTzers (signature) Invoice <br /> Protect Name AGE E�- <br /> Client ❑ <br /> Sample Location Sample TypeDate Time No of <br /> Number Description Water Air Solid Coats sir.+ate <br /> Comp arab <br /> 23 83222 <br /> `o 83223 <br /> 3< 3 83224 <br /> ,e 83225 <br /> D 83226 <br /> 83227 <br /> $322$ <br /> e tSignature) ec re y gni ure <br /> Relinquished-by (Signature) Received by (Signature) bate(TVme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date/Time <br /> Dispatched by (Signature) patell'ime Rec i d,�ary by <br /> / atelTime <br /> I <br /> B� e2 C) <br /> Method of Shipment ` Laboratory#lame <br /> Special tnstructwns e J M.£TnLi WHI K hereby authorize 'her performance of the above indicated work <br /> rSr l"Ifi 0 <br /> G000 OONDITt0N APFR ri;r E <br /> A DOIffl!l lhil,11 <br />