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e>� ttttttttt� tttttttttlf tfti� f� � � fti� � fl• l• � � � � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. <br /> Date 0t - 13-0 Page Z Of Z <br /> 4005 North Wilson Way-Stockton,Califorrila-95205-(209)467-1006-Fax(209)467-1118 <br /> ant a 0 �� �art1 L,rr�, es� 7ity-��rr Project Manager <br /> Sit. J i of Tests Requires! <br /> Phone Number <br /> dD9 - 41&7 -/oo�: t <br /> Samplers- (Signature) \� Invoice- <br /> o)ect Name 'Ly AGE <br /> F l C ' t y G e u ro Y+ , Client ❑ <br /> Sample Location Samp ype No of S� � tc' <br /> Number Description Date TimecomWat 'Grab Air SanNotes <br /> d Donis � ,� I t <br /> O(O t I &0 �20 <br /> 69758 <br /> Ii 69759 <br /> /Cl}�3o r 113 - - I <br /> 69760 <br /> la,1 I o(p 0\0 <br /> 69761 <br /> , <br /> lotei3(? t�)3a1 4335 �i 69762 li <br /> >L1 �c l�til 1)30 / X JXJ X 69763 <br /> f � <br /> /oU201 au 110 1X.5­c, �f � IX I V. 69764 <br /> i <br /> r r s e y (Signature) Receive y gne urs <br /> nquished by (Signature) Received by (Signature) DatelTime <br /> tlinqurshed by (Signature) Received by Mobile Laboratory for field analysts (Signature) g(TA-T <br /> OateJTime <br /> spatched by (Signature) Rale/Time ecat a for Laboratory y at*[Time <br /> W/ 01/ Cold <br /> ethad of Shipment CLa ralory Name <br /> ,4L Omer I�i i�.-# cc'Mabe 1 I <br /> Decial Instructions t hereby authorize the performance of the above Indicated work <br />