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Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnvironmental, Inc. Date OF)- lq-97 Page �_ ofAz� <br /> of Not7henr Califa7tiu <br /> v. <br /> 1803 West March Lane, Suite A-Slocklon, California-95207-(209)956-0264-Fax(209)95CrM700 P2719 x E —J b �• <br /> Client <br /> Project Manager <br /> Cr- �� a T t\A c j a r Tests Required <br /> Phone Number <br /> o - G56 - ()? oy <br /> Samplers: (Signature) <br /> �; Invoice: <br /> Project Name AGE <br /> G CIT. C.4 e V(.D '-'J Client ❑ <br /> Sample Location Sample Type <br /> Date TimeNo. of <br /> Number Description Water olid tet. <br /> Corn p. Grab. Alr Cants. <br /> ��P 11 p } �- 4 � x � s! b Snl� 7�ya8Q f7ar�n I : ) 8 o-15-4-1 e•.�j x <br /> i � � 21 Z785 � • �� �l � �- <br /> -e- 35 ,r r' 35' 1 X 1 x <br /> 1 �3 <br /> 0 x <br /> A. <br /> Re i qurs ad by: sig nalureF Re ive y: i nature' " <br /> r $-�-�r7 oa <br /> c!ti c Q9 0S ^ �? 00 <br /> Relinquished by: (Signature) 4ceived by: (S gnature) DatelTime <br /> J f` <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date[Time <br /> �Ur/] Flo vn F) <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date[Tlme <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: 1 l MF$ I hereby authorize the performance of the above Indicated work. <br /> NQk onl,j rd r MLS• \iij , -T-CLASinvl ier+]Q(- <br /> 0; I'x, 0(00 vL P-1h Q r (D pL T 11S <br /> C119 `To Ve' r v L'iF0+ -+o <br />