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Advanced CHAIN OF CUSTODY RECORD <br /> - _-- GeoEnvironmental, Inc. Date ` l� Page —L of <br /> 837 Shaw Road- Stockton California- 95215- (209)467-1006- Fax (209)467-1118 r 0 43 <br /> Client 1 i Project Manager Tests Required <br /> Phone Number <br /> ac-g q6-7-Ic� <br /> Samplers (Signature) invoice <br /> AGE -R,r <br /> Prosect Name Client <br /> ,2— <br /> ❑ <br /> } Sample Type r <br /> Sample Location Date Time Water Solid No of (! Notes <br /> Number Description Comp crab Air Cants (%1 <br /> 1>'! <br /> Lellx l bs` -` �kjq�( l 2`z� 7; l` X <br /> kq-Z4?- I ; XAXX <br /> `2-iff'6 I KKX Y <br /> I 'IX X N <br /> k`2S7 <br /> X K <br /> 3 <br /> - 3 <br /> e i qurs e y ignalure eceiva y ignature >5a elTime <br /> Re inquished by (Signature) Received by (Signature) batafTilne <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> � II <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment <br /> Labor ry Name ce� <br /> r <br /> _ I <br /> Special Instructions '�( �. � K/ <br /> I hereby authorize the performance of the above indicated work <br />