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A/ <br /> t Advanced V� CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date tL �7 Page <br /> 4005 North Wilson Way Stockton,California-95205-(209)467-1006-Fax(209)467 1118 <br /> Client EA Ll j ttt Project Manager �H- <br /> newl C G Tis Required <br /> Phone Number <br /> Sampiers (Signature) Invoice <br /> Project NameO�--�;��„ 1 __� � ` 1� � AGE <br /> l �oo �r Client ❑ <br /> Sample Location F: Sample Type <br /> Number Description Date Time Water Alr Solid Conts Notes <br /> Comp Grab <br /> - �� � - q - r <br /> r <br /> P-41 <br /> �-Z' 2V � � <br /> 731 I <br /> e inquis dy t 9nature �ace�ivley 1gnature f <br /> .J1�� f f]atelTrme � II <br /> nquished by (Signature) - / <br /> Received by (Signature) DateJTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Trme Reserved for Laboratory by Date/Time <br /> eVethod of Shipment /` er1 Laboratory Name <br /> Special Instructions I hereby authorize t e performance of the above indicated work <br /> s <br />