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t Advanced <br /> -z7., <br /> CHAIN OF CUSTOD ECORD <br /> GeoEn�ironmenta�, Inc. Date »Iz1ou of <br /> Page � 3 <br /> 837 Shaw Road-Stockton, California-95215- (209) 467-1006 Fax (209)467-1118 <br /> Client CP\"— � Project Manager Tests Required <br /> P one N mber <br /> Samp! rs (Signature) Invoice <br /> AGE <br /> Project Name ,�� � Q,, / © Ghent <br /> Sample Type <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description JrAConts <br /> Comp Grab <br /> Mtic ?� k X <br /> 96 <br /> Mue afar eceive y ignature Daterrime <br /> czd2� C f (0�C� <br /> h <br /> Relinquished I e) Received by (Signature) DatalTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatelTime Receiv d r L borato by a [Time <br /> l213IQq of <br /> Method of Shipment Laboratory NaC f �� <br /> I here y authorize the\per rmance of a ve indicated work <br /> Special Instructions � <br /> CJv� <br />