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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvtronmental Inc. Date 23a Page - L of <br /> 837 Shaw Road-Stockton, California- 95215-(209)467-1006 - Fax (209)467-1118 <br /> Client t- �, Project Manager + Tests Required <br /> P ne umber <br /> -ztV24� 7 �� <br /> Samplers (Signature) 'rte Invoice <br /> Project Name AGE <br /> '�� 77V , " Client ❑ <br /> Sample Location Sample Type ` <br /> Date Time Water Solid N0of �(� Notes <br /> Number DescriptionCompGrab Air Conts <br /> 11A 2-3eLq `� 23 a �` -7C)CI 3 <br /> W6 i-,t1 <br /> L 113? 1 <br /> Zoo E <br /> X X X I Low <br /> Relinquished y nature) ecaive y ignature <br /> Date eme <br /> L2- <br /> Relinquished � IZ30 <br /> by (Signature) Received by (Signature) Date1Tlm <br /> Relinquished by (Signature) Received by Mobile Laboratory tot field analysis r7' <br /> S nature) � /� Date/Time <br /> Dispatched by (Signature) Datefrime Re ewed f r Labo oq f Date/Time <br /> �0 1 CIo�L� <br /> Method of Shipment t Laboratory Nam <br /> Special Instructions ,-/ I hereby authorize the performance of the above Indicated work <br /> L/J\ <br />