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� � ffffffffff• tfffff� � I• � i, : it1� tiftfifi� t� � ttfhaC07 <br /> 7 <br /> ( Advanced CHAIN 9FCUSTODY RECORD <br /> GeoEnvironmental, Inc. Date page / 0/ <br /> 837 Shaw Road -Stockton, California-95215- (209)467-1006-Fax (209)467-1118 <br /> Project L4 [ <br /> Client pec f %��gLl �T �� Pests Required <br /> Phone Number <br /> 47 1006 <br /> Samplers (Signature) Invoice <br /> Protect Name �Q AGE,,Eg— <br /> z se - �► x'- Cheat p <br /> Sample Location Sample ype No of i .�� <br /> Date Time Water Solid " 5 r Notes <br /> Number Description Comp (arab Air Conts <br /> tai oEl (� 1l5 `T Al <br /> i <br /> quis e y ature Receivedy igna(ure telrime <br /> e All, -ya A.4 666 <br /> ralufflVished by ignature) d Received by (Signature) DatelTtme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DalelTime Received for Laboratory by le, Dat !Time <br /> Method of Shipment Lab tory 7J e z I <br /> Special t"SttUrtiont V I hereby thorixe the p rformance of the above indicated work ' <br />