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j Advanced CHAIN OF CUSTODY RECORD <br /> ---- _ GeoEnvironmental, Inc. q Date Paye �- <br /> 837 Shaw Road - Stockton, California- 95215-(209)467-1006- Fax(209)467-1118 <br /> Client Aim ' Project Mana er <br /> L ,.._. Tests Required <br /> Phone Number <br /> 00 1 SSG," G <br /> Samplers (Signature) Invoice <br /> AGE FK <br /> Protect Name / � ��� � CI e t El(� 1 �G <br /> Sample Location Date Time Water Sample Type Solid No of `` '� Notes <br /> Number Descnption Comp Drab Air Cants <br /> f + <br /> I- w O l 0( 3 <br /> 74412 t� <br /> 74413 <br /> ✓�'pIr�� '(3 ref Z.�` --� � <br /> FM 801 0 � 3 74414 <br /> I t <br /> &&0 ci1Cyj ? 74415 <br /> t <br /> t <br /> e Inquy nature Received y gnatura oateM e <br /> Reli shed by ignature) Received by (Signature) �� DalerTime <br /> Relinquished by (Signature) Received by Mobile Labgratory for field analysis (Signature) DaterTime <br /> Dispatched by (Signature) Date/Time Rec va for aboratoryp aalme <br /> Method of Shipment Laboratory Name <br /> CV-�416dL— rue jj[�K- "'L <br /> Special Instructions COOD JITi'GN s a y autho a the performance of the shove Indicated work 1 <br /> .44PR�A <br /> c t ;n <br /> a� <br />