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( Advanced CHAIN OF CUSTODY RECORD <br /> _-_- GeoEnvironmental, Inc. Date Z -Page ' f <br /> 837 Shaw Road - Stockton, California -95215 - (209)467-1006 - Fax(209) 467-1118 <br /> Client Project Maytag <br /> ---�- /G� Tests Required <br /> P one Number L <br /> ? Gem <br /> rs (Si atur ) Invoice <br /> Project Name � � f-ce-WOFII AGE f2', <br /> Client ❑ <br /> Sample Location Sample TypeDate Time No of <br /> Number Description Water Air Solid Conts Notes <br /> 1� Comp Grab <br /> --1 <br /> Mw7b 11 q3 <br /> 94 <br /> lam 3 - , <br /> e tnquis e y tg aturej eceive y ignature tefrime <br /> 4 y <br /> Reltnq shed by (signature) V Received by (Signature) DatetTtme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date/T e <br /> Dispatched by (Signature) 1 Date/Time R e for Laborawy by Iteffirne <br /> Method of Shipment Laboratory e <br /> Special Instructions I herebytho tze the performance of the above indicated work <br />