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I <br /> Advanced CHAIN OF CUSTODY RECORD <br /> 1�1GeoEnvironmentai, Inc. [�:Z Date Page <br /> 837 Shaw Road -Stockton, California- 95215- (209) 467-1006- Fax (209)467-1118 <br /> Client Project Man r <br /> Tests Required <br /> P one N!ymber <br /> - te" (SI ature) UU Invoice <br /> Project Name r � ` x AGS�� Client ❑ <br />� <br /> Sample Location Sample TypeDate Time Water Solid No of Notes <br /> Number Description cum arab Air Conts <br /> P <br /> :�- <br /> i <br /> 3t:EA T,9n OD p �} <br /> y T � <br /> e rnq s e y nature eca ve y gna4ure elelT� <br /> ehnq she y ( i nature) VReceived by (Signature) e/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (S19nat-ure) DaletTime Received for Laboratory by'L_1_ <br /> Dat /Time <br /> Method of Shipment L& � abor lar Na <br /> _ r / /� <br /> F - L (} <br /> --Special Instructions 1 hereby atf or a the ormance of the above indicated work <br />