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RECORD <br />Advanced CHAIN OF CUSTODY <br />Dat®"1�'D3 Z <br />- = = GeoEnvironmental, Inc. -page—Lai <br />' ro <br />837 Shaw Road - Stockton. California - 95215 - (209) 467-1006 - Fax (2Q9) 467-1118 ro <br />ro <br />m <br />j j <br />i.T N18 m <br />Client Tests � 01�� i W <br />Number <br />Samplers: (Signature) �Q y I . <br />Project Flame.�..�C � ~'� AGE ®. <br />Client <br />® � D <br />Sample Location Jimnjyp, 0 leo. of <br />Number Description Date Time Wer Air Solid Cora � Nous m <br />Comp. Grab. n <br />mp k /®4 0 O i, ser -) <br />Usk o tzol <br />ns h /04E1W-00 <br />T- /Ocl 3 %,tom c.�► 11 <br />� 3 111 <br />Sl'Kfd p'11�3 S°�-�c, iG. e wa <br />�s <br />had y: gna urs) RecoNsd W. 155inaturei Date/71m <br />�/� 15-03 J 0 X03 cn <br />nqu s ed by: ( godwa) Received by: ($Igoaturs) Oate/'Time N <br />N <br />Relinquished by: 819nature) Received by Mobile Laboratory for Held analysis: (819rtature) DatelTlme Rei <br />Dispatched by: (819nature) <br />Method of 8hlpme <br />Special Insltuotlons: <br />vcT nl ah,.+ <br />N <br />-�7 <br />atelTima 00 <br />/o : o -i `° <br />Laboratory dams o <br />Cit ( Testi, <br />/ hereby authorize, the porlormance of the above Indicated walk.CD <br />A <br />%� <br />