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( Advanced CHAINO CUSTODY RECORD <br /> - =- GeoEnvironmental, Inc. Date Page -- of� <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client Pro ect Man a er <br /> L Tests Required <br /> PPaneN: ber� <br /> les rgnature) Invoice <br /> Project Name <br /> '`j' AGE <br /> 4Location <br /> t ClientSample Sample Type <br /> Number Description Date Time Water Air Solid Conts of Notes <br /> Comp Grab <br /> 3 11 12 -3 <br /> elinq is a ign re ace e (Signature) <br /> y teffime <br /> Refinqu e y (Signature) —e/—[�� Recai d b <br /> y { ignatur Z !� Date/Time <br /> -Relinquishedby ignature) ec i ed by Mobile Laboratory for field analysis (Signature) DetelTime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> Date/Time <br /> Method or Shipment Laborato llama <br /> Special Instructions <br /> I hereby orae t erfor nce of the above Indicated work <br /> 7� • <br />