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1, � � � I• � � � � � � � � ■� i_ i_ � � <br /> Advanced CHAIN PF CUSTODY RECORD <br /> - Date (d ' Page - <br /> " GeoEnvironmental, Inc. of <br /> 837 Shaw Road-Stockton, California-95215 - (209)467-1006- Fax(209)467-1118 <br /> Client Prpmp M nag r <br /> , Tests Required <br /> P oneumber 4 <br /> 11 qW 600 <br /> Sa I's [S attire} Invoice <br /> Project Name ,rAGE <br /> Client ❑ <br /> Sample Type ` <br /> Sample Location Date Time Solid No or ////Notes <br /> Number Description Water Air Conts <br /> Comp Grab <br /> V o Z., 0! <br /> /a 2-0 <br /> Wquished <br /> g lure ignature at fTiruq(&gnatur } fiocewed by (Signature) 71 Oteffime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis ( gnature) DatelTune <br /> Dispatched by (Signature) Date[Trme Recery r abora by Drm <br /> atelTe <br /> 1/ V K— 0 G C� <br /> Method of Shipment Labor o Nae <br /> Spectat tnsttuc*ms I hereby uth rize he erfor nce at She above Indicated work 1 <br />