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( Advanced <br /> ! CHAIN OF CUSTODAECORD <br /> =- GeoEnvironmental, Inc. Date 4 c Page —3— of—,3- <br /> 837 Shaw Road - Stockton,California-95215- (209)467-1006- Fax 1209)467-1118 <br /> ClientProject Manager <br /> t I fv Lt Q , �1lr / C r Tests Required <br /> d ( r %Q Phone Numberne <br /> o �v <br /> Samplers (Signature) a Invoice <br /> AGE <br /> Project Name �' IJ / J' �� �► Client ❑ <br /> v <br /> Type TypO <br /> Sample Location Sample <br /> Number Description Date Time Water Air Solid Co°los Notes <br /> Comp Grab <br /> i wX o3o--f,63M UJ 715 03,o'Y03 n$ <br /> V 430 V hl a Jq4 67 67 <br /> c3 V Wd,A 30 01517 <br /> VW 3A b 3,74 e.3 V W 3,"9- <br /> eh i ed by (Sign lure) ecewe y ignature D te17� <br /> 33 <br /> Reh ed by (Signature) Received by (Signature) Data tme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field an Si ator ) DaterTime <br /> Dispatched by (Signature) Date/Time Rec ova r Labo tory b �510 <br /> Dale/TTiime <br /> Method of Shipment abokato <br /> Special instructions 1 hereby authorize the performance of the above indicated work <br />