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1 l 4 1 t 1 1 1 1 l 1 I i 1 I l 1 1 1 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> �. Inc. bate Page �Z of J <br /> -F GeoEnvironmental, <br /> Ccrlifnrnia <br /> 1303 West March Lane. Suite A-Stockton. Cakiiornia-95207 -(209)956-0264 - Fax (209)956-0700 0?`, h <br /> Project Manager <br /> Client � � 1 � � Tests Required <br /> Phone Number ;% <br /> Samplers: (Signature) ' �/� j Invoice; <br /> AGE <br /> � <br /> Pro act Name K `�� /a l✓�L � / � � � ;�/� � � Client <br /> Sample location Sample Type Solid Ne. of / `r' j j '/j Nnta_S <br /> Date Time <br /> Number Description ` comp at arab Air Conts. j ' " ' / r <br /> ` f. � 7234 <br /> -� 'P 1�G,-f4--�'tJ !1 i� �°I 1�r S IS i 71235 <br /> Z_fit, 1 n r f 3� ✓; y � I � <br /> 71236 <br /> 7123.7 <br /> i 71238._.._ <br /> f?_ 71239 <br /> tnZ,�� n �jam -✓ � � � <br /> + Lf" = 71240 <br /> ��� r✓� k i I � ! I I <br /> elinqui�hed by: (Signature) Rec IVC by: ( i //_/ —�/(* Date/Time <br /> Relinquished by: (Signature) R eived by. (Sig lure) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date[Time <br /> Dispatched by: (Signature) Datelfime Received lot Laboratory by: Date/7ime <br /> Method of Shipment: �7 Laboratory Name <br /> ;41ej.��ex /J <br /> Special Instructions: I hereby authorize the perlormance of the above indicated work. <br />