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� �I♦ � I♦ � � I♦ � � � � I♦ I♦ � I♦ � �� � <br /> 4 Advanced CHAIN USTODY RECORD <br /> [1 <br /> - GeoEnvironmental, Inc ,� �r� Date Page -_ of <br /> 837 Shaw Road- Stockton, California 95215 - (209)467-1006- Fax (209) 467 1118 <br /> Client _ Pro,lexWana Tests Required <br /> Ite fla*1one N i� L /00"fo <br /> Sa ars (S aturey Invoice <br /> Pro ect Name AGE <br /> ! ,{ �y 2-0 Client <br />�= Sample LocationSample Type <br /> Rafe Time Water Solid No of Notes <br /> Number Description Air Gants <br /> Comp Grab <br /> a 3!- <br /> a i qui a nat e) Received y igneture O tis fine <br /> Relinq risked by (Signature) Received by (Signatura) DA/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) f}aYelTime <br /> Drspat•hed by (Signature) Date/Time Received for Laboratory by tafTime <br /> lV <br /> Method of Shipment Laboratory Nam <br /> Specint Instructions ICflJt' 1 here y Ruth the perform-#hce of the above Indicated work <br /> GOOD CONDMoN <br /> READ S1 APPRQPlLIATg <br /> ECULORINATEF 1N PRESCRVED[N LAB�^,,� <br /> _ --itEt�8t3r VOAOdea <br /> �y4 1 ! <br />