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� w t�Ittt♦ t1• � � � �� I)� � itti■fiiiir iti• i• i• tl• i• � <br /> Advanced 0 b(3� ) CHAIN OF CUSTODY RECORD <br /> I 4 <br /> GeoEnvironmental, Inc. Date Page —�— of <br /> 837 Shaw Road - Stockton, California- 05215 - (209) 467.1006 - Fax (209) 467-1118 <br /> Client Pr 'ect-manager <br /> Tests Required <br /> hone umber <br /> Sa rs: (Signature) Invoice: <br /> Project Name ° X AGE <br /> r*A- a4'j J 0 �`' Client ❑ <br /> Sample Loc ionSample Type <br /> Number Description <br /> Dat Time Water Air Solid Contsf Notes <br /> Comp. Grob. <br /> w © I 0 A- <br /> MW- <br /> A&U <br /> �.� <br /> Relinquish y: gnatur eceiva y: gnature Q le(Fime <br /> ; _Z;6 <br /> Relinquis ed by: US g.nature) Received by: (Signature) <br /> TOY Dal lTlme <br /> �� <br /> 000D C <br /> Reli 4WAgE JLrr UJrfUATJJ Fiecelved by Mobile Laboratory for field analysis:(Signature) Datelrtme <br /> DECHLORWATED CONINE <br /> W ��—.. <br /> 13RVED IN <br /> VA 2 <br /> DisP1U1"1'1*A111fte u eAi.B t01 Dalef lrne Received for Laboratory by: atelTi e <br /> Method of Shipment: aboral y a <br /> Special tnitructions: I hereby aut rite th der rmanco of the above indicated work. <br />