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( Advanced CHAIN OF CUSTODY RECORE3 <br /> GeoEnvironmen al, Inc Date page - - _ f � - <br /> 837 Shaw Road Stockton California 95215 - (209) 467 4006 Fax (209) 467-1118 0 s 0 <br /> Client +� 41- Protect Mana er Tests l�ec>ufred <br /> 4>� <br /> P one N mberj <br /> Samplers (Signature) 4 Invoice <br /> J / i AGE <br /> Project Name � --'� Client E]_ - i <br /> Sample Type <br /> Sample Location No of tt / i ' <br /> Date Time Water Solid /� � Notes <br /> Number Description Comp Grab Air Conts / ,( <br /> elin uis e ( gnalure} ��' eceive y (Signature) <br /> = Reli quashed by nature) Received by (Signature) pate/7�me <br /> MOD CONDI' <br /> Relinquished btims �iSSrXVE1] obde Laboratory for head analysis (Signature) c _ � Date/Time <br /> Dispatched by Dalefrime r f.aborataryy�yVy gatvfrim� <br /> Method of Shipment La Wiry <br /> t' f C <br /> Special Instructions 1 I hereby authorize the performan a of the above indicated work <br /> i „ I <br />