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(� Advanced CHAIN OF CUSTODY RECO p <br /> GeoEnvironrnentall enc. Date 3' page f Of <br /> 4005 North Wilson Way-Stockton,California-85205 (208)467.1006-Fax(NO)467-1118 CS~ <br /> CS <br /> Client l►,� �S C � Project Manager m <br /> Tests Required o <br /> Phone-Number N`J <br /> Samplers: (Signature) N <br /> Irwoice: C9 <br /> Project Name � � A <br /> AGE �; <br /> / Client ] <br /> Sample Location Sample Type .` p <br /> Number Description Date Time Water Air Solid <br /> of <br /> Notes <br /> comp. Grab. xx <br /> X33 _70 <br /> .326©3 <br /> SBS-- J � - ��0 - 32604 <br /> 3 - b 3260 <br /> 2 m <br /> 32606 <br /> -23 3260 7 <br /> CD <br /> z <br /> Rel nquos ed ( ignature eceive y: riig,.natures� J f <br /> -,M , am 7!p! �� 9 �Gt/yL� � I�uA� ( �� t}atefrime <br /> Re inquished by: (Signature) Received by:(Signature) <br /> Datelf i me <br /> Relinquished by: (Signature Received by Mobile Laboratory for field analysis:(Signatute) <br /> DateMme <br /> Dispatched by:(Signature] DatelTime Receiv For aboratory try; <br /> Date(Tims <br /> Method of Shipment; r Laltioratory Name <br /> L r D <br /> Special instructions- 7 <br /> I hereby authorize the performance of the above indicated work. <br /> i MEAS �- c^r , _ VOAS �dETr��S OTHER <br /> t,O00CnND11110N t,--- LO <br /> xF 4t�l ATE <br /> Ary •� <br />