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r r rr rr <br /> CHAIN OF CUSTODY RECORD <br /> { Advanced <br /> Date Page __4 of----� <br /> GeoEnvlronmental, Inc. <br /> QAC,e,5 357". <br /> 4005 North Wilson Way-Stockton California 95205-(209)467-1006-Fax(209)467-1118 <br /> Client Prop <br /> ro Ma ager Tests&quired <br /> M , 4 <br /> P one umber <br /> S p rs {Signat re) X invoice <br /> > AGE 1 <br /> Project Name�A� cl'� P/Oi��, Client [:1 Sample Type � <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description comp Grab Air Conts <br /> 5692i <br /> 56922 <br /> 5923 ' <br /> 56924 -k <br /> — <br /> n 56925 <br /> 3 - <br /> e Inq s e y Ignatu ) Received y (Signature) P to M, <br /> � 5Ub <br /> Fb <br /> Reltriquished by (Signature) Received by (Signature) atelTtme <br /> I <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) "' Date/Time <br /> Dispatched by (Signature) Rate/Trma wad for L�abPratory by ` Data rime <br /> i V t°rn� 2 J ,560 m <br /> Method of Shr e <br /> r i Laborator Na 1. <br /> Special instructions fJ + I hereby thofr a the p fformance of the above indicated work <br /> CIA MAS I 4r NEDI SI TO <br /> {CFI3� R I IN1,`IYIC'11 <br /> I f t5 T 41 I' it ll� �r <br />