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CHAIN F CUSTODY RD <br /> Advanced Date Page —1 ar <br /> = GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006- Fax(209)467-1118 <br /> Pro -- Tests Required <br /> nt <br /> p miner <br /> I rriolce <br /> S ignature) <br /> AGE <br /> L Client ❑ <br /> ))ect Name <br /> Same a Type o of � Notes <br /> Sample Location Date Time Water Solid Conts <br /> Number Description Comp Grab Alir <br /> 9 <br /> at <br /> y net e) <br /> eceive y ignature <br /> Date/Time <br /> lei+ngwshed 6y (Signature) <br /> Received by (Signature) <br /> Dole(r+ma <br /> relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> atalrime <br /> tato Tlme Received for boratory by <br /> )rspatched by (Signature) <br /> Laboratory a <br /> Method of Shipment <br /> ! hereby a rixe the arformance of the above indicated work <br /> Special Instructions ' <br /> fL � <br />