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Advanced CHAIN OF CUSTODY RECORD <br /> F <br /> GeaEnvironmental, Inc. Date - Page �� of <br /> of Not-thern Cti ijivnia <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 <br /> � <br /> C :� �t �. Project Manager <br /> Client r� � � � r � Tests Required <br /> Phone Number <br /> t <br /> Samplers: (Signature) Invoice: <br /> AGE .� <br /> Project Name r i <br /> —S .x.._ 'C? O ��. Client4b <br /> Sample Type r� °' <br /> Sample Location Date Time Water Solid 56067 No. of <br /> Number Description Comp. Grab. Air Conts, <br /> JI <br /> 56068 <br /> I � <br /> .- , �, r � � ✓ j 56069 <br /> 56070 <br /> I; <br /> �r� �f /� ; , ✓ <br /> 56071 <br /> 11 56072 <br /> M6-1i–q-6/—she J- y: (Signature) ecei a by: ( Igrtature + , E)ate/Yi le <br /> Jl J [ �!/GLS c✓ y !�`' x7 <br /> 73 <br /> Re'l'inquished by: ( ignature) G®ived by: (Signature) <br /> I <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) 56073I <br /> I <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> _ A . <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />