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AdvancedCHAINi OF CUSTODY RECORD <br /> ,rf <br /> C,J Date Page of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton, California-95215- (209) 467-1006-Fax (209)467-1118 <br /> Client Vcv-,, 7�—�>a Project Manager Tests Required <br /> t <br /> samplers (SI ure) h`�, r Irw°tce <br /> AGE <br /> Project Name ,� C-0 Client ❑ <br /> Sample Type <br /> Sample Location No of r !J (Votes <br /> Number Description Date TimeComWat drab Air Solid Conts <br /> AWu <br /> > ( �z <br /> A-4AsLJ <br /> Inquls y igture) ecaivA y tgnalura Daleff{a/ane <br /> c1�t G Z C.5" 1 �x'17 k: <br /> DatelTme <br /> Helrn4d shed by (Signature) Received by (Signature) <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis ( nature) Oaleffime <br /> h <br /> Dispatched by (Signature) Datefrrme ore <br /> Aece�ve t at by , me� <br /> 4 <br /> Method of Shipment r Laboratory Name <br /> I her eb authoNze t rforritanc f the above indicated work <br /> Spacial Instructions ,�— <br />