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t Advanced CHAIN OF CUSTODY RECORD <br /> _-- GeoEnvironmental, Inc. Date Page a, <br /> 837 Shaw Fload-Stockton, California-95215-(209)467-1006-Fax(209)467-1118 <br /> Clientv Pr Manager Tests Required <br /> P,40ne Num <br /> Samplers (Signature) Invoice <br /> Project Name (� �' /9 r AGI= <br /> `~ -' (.-��, ±1 - L f Client ❑ <br /> Sample Location Sample Type No of J(� <br /> Number Description Date Time VYater Air Solid Corns Notes <br /> Comp Gish <br /> �t �� �' <br /> f7 LJ <br /> tl119 Y\A Y I <br /> eJ�uj i ignature) Received by (signature) Dat rr3me <br /> ,r -Z SC <br /> Relinquished 57 (Signa ure) Received by (Signature) DatefTiw <br /> Relinqu+shed by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTtme <br /> Dispatched by (Signature) Date/Time Received for atoryby Date rime <br /> 11 -211 <br /> l <br /> ' <br /> Method of Shipment Laboratory Name <br /> re 's t< <br /> Special Instructions %K [� I hereby authorize the performance of the abov ndicated work <br />