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/� ��-V <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnviron mental, Inc. Date 1()-Z3 -01 Page of Z <br /> \ J 837 Shaw Road - Stockton California - 95215- (209)467-1406 - Fax (209) 467-1118 <br /> Client c r,+f CA Project Manager e r Tests Required <br /> ��.K�-e� Se;v��c�- S-� <br /> Phone Number <br /> Samplers: (Signature) invoice: <br /> Project Name `�?XX � AGE [34 <br /> Client ❑ <br /> Sample pe <br /> Sample locationo. ` <br /> Number Description Date Time Water Air Solid Cont �� Notes <br /> s <br /> Comp. Grab. <br /> >SL AC e 4-2-5-c', J9415 x � x 1 Z . <br /> 151110-1,0 144fl: <br /> � �n5�r- If�--23-csl i.SU�. ll,� � � , b5G <br /> }} . _ <br /> /I 0-A 3G lck+1)lL -�rd f7je:' ?i .A 5 s <br /> Sty,l I r:����l 5}�;4k P; 1e �.:,-F 1�-23-u, l�l� � � � ► n�� �, 1� <br /> 10:L�1 Suck- I le- west Id-L3 Vo 15 Z ( op <br /> elinq d y: ig re) Received by: (Signature) <br /> D te(Time <br /> Reli wished Si naturei��ZJ ] JVA <br /> q ( 9 ) Received by: (Signature) 7` `'l � Datelrime <br /> Relinquished b nature <br /> q y� (Signature)) Received by Mobile Laboratory for field analysis; {Signature) tiH-C-�J � DatelTime <br /> Dispatched by: (Signature) Date[Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> GAL Qve f\, }9- <br /> Special Instructions: I hereby authorize the erformanof the above Indicated work. <br /> �' <br />