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t Advanced <br /> CHAIN OF CUSTODORECORD <br /> GeoEnvironmental, Inc. Date L 2-0 Page of r <br /> 837 Shaw Road Stockton,Caldomia-95215-(209)467 1006 Fax(209) 467-1118 1 , 5- 7 _ <br /> Client � f � ProiLect <br /> � rTests Regured <br /> Phone Number <br /> Samplers (Signature) Z' /Invoice <br /> / a <br /> f _ <br /> Project Name '^ �r AGE '- <br /> C ( r Uk- V Clfm <br /> Sample Location Date Time Sample Type Solid No of � � � / L Notes <br /> a <br /> Number Description A �j <br /> Comp Grab <br /> Air Coots <br /> i- <br /> 0 eltlZ 2DI5 <br /> Relinquished y ignatureReceived y (Signature) <br /> r^ DaterT�mE <br /> Relinquished by (Signature) Received by (Signature) LJl Daterrime <br /> ffelhnquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datelrime <br /> Dispatched by (Signature) Date/Time calved for Laboratory by DatefTime <br /> Method of Shipment rry Labor o Nam eG / <br /> t tJ Z16C <br /> 13pecial tnatfuctions r I hereby authorize the performance of the above indicated work <br />