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I <br /> Advanced CHAIN OF CUSTODY'RECORD <br /> GeoEnvironmental Inc. c-c Date d Page i Ot- <br /> Zen z <br /> 837 Shaw Road Stockton, California- 95215 - (209)467-1006- Fax (209)487-1118 <br /> Client i._ Project Mager <br /> 147�C J Tests Required <br /> �( ( n ! ! h <br /> Phone Number <br /> to oU <br /> Samplers; (Signature). Invoice: <br /> Project NameJ AGI= <br /> 11 o ✓ Client ❑ <br /> Sample Type <br /> Sample Location Date TimeNo- of Notes <br /> Water Solid <br /> Number Description comp. ( fab. Air Conts. <br /> 899.8 <br /> V <br /> Vro <br /> Re[nquis a y: ign urq�, eceive y: (Signature) <br /> DetalTime <br /> 17FC) <br /> Reiinqu ed by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) 8ste11 ime <br /> Dispatched b (Signature) Dale(Time Received far laboratory by; , <br /> P Y� ( 9 [)ate/Time <br /> I O'cz <br /> Method of Shipment: to a <br /> S ectal Instructions: I hereby authorize the performance of the above indicated work. <br /> `1 vvu. <br /> f�l <br /> •J <br />