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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, .Inc. - Date 04-to"ir-oil Page l or I <br /> V;•. of Monheni Calijnrnia <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956.0700 - <br /> ClientProject Manager <br /> C41 e)eaT Ccr.rre} E _ T. C,.- Tests Required <br /> Phone Number <br /> 5ID- oabLl_ <br /> Samplers: (Signature) Invoice: <br /> Aroject Name t' " AGE [v]� <br /> 'n CW C4 Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No. °t /Q�Sl �4' Notes <br /> _ Comp. Grab. Air ContS. <br /> GW — )ELL# I�j -o 0 ot'.bo 7C 3L^"e� ,c <br /> e mgws a y: ignatwe Mecorved-Ey: ( ignatwa <br /> QD <br /> Date/Time <br /> 1 <br /> elinquisl d bl (Signatmo) J rnV 1 ` �(A l'Vyg <br /> Received by: (Signature) - - Datellime <br /> netinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) - Date/Time <br /> Dispatched by: (Signature) Date/Time - no for Labor y by: Date/Time <br /> �✓ v Y-/v ac, <br /> Method of Shipment: Le oratory Name <br /> —�� �sJf-aN �rHT _ CAs-71 I CC4 <br /> Special Instructions: - I hereby authorize the performance of the above Indicated work. <br />