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t► <br /> ` Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc <br /> `} Date 2 Page --L of , <br /> 637 Shaw Road - Stockton, California- 95215- (209) 467-1006 - Fax (209)467-1118 <br /> Client r t Project Manager <br /> Tests Required <br /> 7T& <br /> p one mber// <br /> S ers ignat re) Invoice <br /> AGE . <br /> Project Mame r , <br /> A CLJ��LL Client ❑ <br /> - Sample Location Sample Type No of <br /> _ - Date Time Water <br /> —_- Nljmber Description Date Sole Conts Notes <br /> Comp arabIL <br /> I-/ I X _ <br /> /A C �z 1 l t) <br /> I x <br /> Cao COI`t!} E <br /> e In uis y { iOTOM <br /> ure ace Wed y (Signature) NN iAs D telTrme <br /> 2i-- — = <br /> Relinuis <br /> cihed 5y (Signature) Reserved by (Srgnsturo) lrH oate/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) OateTTime <br /> T's—patched by (Signature) Rata/Ttmo Rec Laboratoryby,,,-, �l` Olde rme <br /> ethod of Shipment Labo► a <br /> MNa <br /> tu;If{f � f <br /> gpecial Instructions l hereby th rize th or ormanca of the above indicated work <br /> tcf �„^�✓ <br /> REMI)041.'o el - — <br /> SEALED a �ir/'7IC <br /> SEALED&INTACT VIA L <br /> - S <br />