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• • l2- - 0 / 07-` i <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental Inc. <br /> Date ` �` Page l of <br /> 837 Shaw Road- Stockton,California-95215-(209)467-1006 - Fax (209)467-1118 <br /> ClientSir Project Manager Nd bL�; C-'0 Tests Required <br /> hone Number <br /> '2�AL46 7--[006 <br /> 'Samplers (Signature) Invoice <br /> Project Name tt � j �" AGE <br /> � "�t'S.S C�1'1T1`C ` Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water Solid No °f Notes <br /> Number Description a <br /> Comp rab Air Conts <br /> M\11) k oc) X <br /> AAw 2A t( X153 x <br /> 1W 2-13/ 0 kkLJ 2 <br /> W A&A; `3 i( 13�� <br /> '-1 t -t 11) x x x <br /> Fnqups e eReceived y (Signature) Date/1'iTt%u�-Z <br /> Rei{nquished by (Signature) Received by (Signature) ate rme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/time Received for Laboratory by Date/Time <br /> Method of ShipmentLabor ry ame <br /> CC <br /> Special instructions i/ I hereby authorize the performance of the above Indicated work <br />