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tti_ t;• I•I I� M IM I= MM <br /> • 0 <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> -- GeoEnvironmental, Inc. Date A . r <br /> Paye ...Z,.— of� <br /> 837 Shaw Road-Stockton, California 95215- (209)467-1006 Fax (209)467-1118 <br /> Client „ L �S Project Manager <br /> Tests Required <br /> Phone Number <br /> ec'x'- l L t <br /> Samplers (Signature) Invoice <br /> Project Name �j�/ Cy.-// �� I` � �, AGIr,eq— <br /> CC C� r Client f1 <br /> Sample Location Sample Type 1 <br /> Number Description RaCe Time Water Solid No <br /> of <br /> Air Con <br /> Comp Grah "'$6498 <br /> 86494 <br /> 'I d ly,s _ ,.� 86496 <br /> J � � � � E6496 <br /> 9 LA..� /a , is a� �/ + 86407 <br /> V86498 <br /> a inquis y -gn re Re va <br /> y gnatura <br /> 421,4".4 <br /> l I [ , <br /> L10 <br /> Resin d y ( gnatur Received by (Signature) kw�l� <br /> Relinquished by [Signature) Recelved b s <br /> Y Mobile Laboratory for field anatyxis {Signature) 86499 <br /> Despatched by (Signature) Datafrima Received for Laboratory by <br /> Ost6/Trme <br /> Method of Shipment Laboratory Name <br /> Special instructions 1 hereby authorize the performance of 1116 above indicated work <br /> ' ,„r-r-+r-ice •/� —�—�_. <br /> /7 _� Tom..���- t r n <br />