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� Advanced <br /> CHAIN OF CUSTODAECORD <br /> - = GeoEnvironmental, Inc. ° e P.. <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1006 - Fax(209) 467-1118 <br /> Client Mc , Pr Manag r 'k Tests Required <br /> Poone Number IM6 <br /> samplers (Signature) Invws, <br /> Project Name , AGE <br /> Lchard ❑ <br /> Sample Type <br /> Sample Location Date Time No of <br /> Number Description Comp Grab Water Air Solid Notes <br /> w AW z <br /> 1W MW q <br /> 0C mt'o 6 <br /> 6 <br /> e 1nquPs e y rgn tui Received y gnatura Pate, e <br /> CQ <br /> Relinquished by [ ignature) eceived by (Signature) ST/AT bateftime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DetelTama Received for a to by talTime <br /> I <br /> Method of ShipmentI Laboratory Name <br /> C c, Ca -Ce C <br /> Spectral Instructions II <br /> !f I hereby authorize the performance of the above indicated work <br />