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a� ffl� s ftp ftp tutu ti <br /> Advanced CHAINI OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. C-) �Ic5vt-C) Date 13 If,,-L— Page <br /> 837 Shaw Road-Stockton, California -95215- (209)467-1006-f=ax (209)467-1116 <br /> Client Project Manag r <br /> AJ AR, Tests Required <br /> P ne Number <br /> t j <br /> $amp ers (Signature) Invoice, <br /> Project Na AGE ET' <br /> Client 0 <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water Air Solid Notes <br /> Camp G►ab <br /> Conts <br /> rw —LIZ <br /> Kr: V T -z <br /> V�DM 5TM AMRORIATIE <br /> d.n <br /> He inq i e ign ure Received y (Signature) ;Dtt�,Twe <br /> me <br /> 7 9 1 <br /> Relinquishedby (Signature) Received by (Signature) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date[Time <br /> Dispatched by (Signature) Daterrime Recalvad for Laboratory Date/T me <br /> Method of Shipment o► to <br /> U <br /> Special Instructions I hereby thorize th performance of the above indicated work <br />