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� � � � � � � i i f� rf� �1if� l• il! t>w � <br /> _CHAIN OF CUSTODYRECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Dace f -23- Page of <br /> 837 Shaw Road-Stockton, California-95215- (209)467-1006- Fax(209) 467-1118 <br /> ClientPraject Manager <br /> ��er a � L,41e Q.�, Tests Required <br /> i <br /> Phone Number <br /> Q09 - Ll(, 7 `loo <br /> Samplers (Signature) i. Invoke <br /> ti <br /> Project Namef D} AGE <br /> U r,4 e s< �a C3 04 �" �w e r'� ` x� Client L <br /> Sample Location Sampi ype No ofr?` �,�' V <br /> Number Description Date Time Water Air Solid Conte �q Notes <br /> Comp Grab <br /> 14,1Sa0 &_ M w - I z-7z-oi /6 V2 X I 1XI X <br /> >`�5f, t:5222UZ Mw� t 2--z 2-az / 7,57-6 1 XI 1XI X <br /> k'As4/01Z20z M W -.Tc- Z-2201 1245 X x I X1 X <br /> U45' 07-2,10-1 PN L') -S� �, 2-tx•�L 115 I X x X x <br /> 'W'*022201 MLJ-Se -L2-c3t I 0 X X X X <br /> 1"VOZZZ07- (P-6 A30 0 <br /> e rnq e y (Si lure starve y ignature OatelTime <br /> Re cashed by'(SigrfatuK Received by (Signature) Date(Time <br /> Y ti y <br /> 1 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> i <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> rAl C Te(.4 <br /> Special Instructions 1 hereby authorize the performance of the above fndwated work <br /> 11 <br />