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• ! i <br /> I Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. DareHA-1(0 Page -2- _of-z3L— <br /> II `�s✓ E� <br /> of Northern Culrfornrrt <br /> 18D3 West March Lane,Suite A Stockton California-95m7-(209)8564)264-Fax(209)956-0700 -?(P33AA&EV95 J <br /> Client Pipllect Manager Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice _9 <br /> Project Name Z.. AMt AGS [per 3 <br /> 114 Client ❑ <br /> Sample Type <br /> Sample Locabon Dale Time No of in <br /> Number Description Water Solid Notes <br /> Comp [arab Air ContS <br /> 71289 <br /> CD <br /> , 71290 <br /> �1 <br /> 10!6' ✓ t — — 1 0? <br /> -�� t 2 ✓ 7 2 9, __ <br /> 71293 <br /> r <br /> 44clL.A 7129 <br /> ' io ✓ 1 71295 <br /> e inqu a nature ep y 9 <br /> geimquiahe by (Sr nature Y 9 G� &4*9 ) eived by (Sign tre) Date/Time <br /> 3elinqu shed by (Signature) Received by Mobile Laboratory fat field snatyeis (Signature) Date/Time <br /> )iapatched by (Signature) Date[Time Recaivad for LabOWAY by Date/rime <br /> dethod Shipment Laboratory Herne <br /> M [ <br /> special instructions Q 1 hereby authorize the performance of the above indicated work <br /> r6 `pfjS 0 �,� ry <br /> GOODCONDm <br />