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r r r r �r .r r r r r wr r r r r r ■r r r <br /> 0 <br /> Advanced CHAINF CUSTOD RECORD <br /> DateTPage 2-- of �- <br /> .. - ,,,.. GeoEnvironmental, Inc. <br /> 837 Shaw Road -Stockton, California-95215 - (209)467-1006- Fax(209) 467-1118 S -A064 <br /> ClientProject M ge <br /> Tests Required <br /> 1 , 1 <br /> Ppone Number <br /> �;zoO YV Im6 <br /> S rs: (S' ure) Q Invoice: <br /> Project Name AGE <br /> . Client <br /> fit 'l' ❑ <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water Air Solir C nts. Notes <br /> Comp, arab. <br /> 1O - a <br /> e in a (Signature) ecSIV6 y: (Signature) ate/Ti <br /> C <br /> &V <br /> Relinquished b . (Signature) - Received by: (Signature) Date►Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) DatelTime <br /> SIr <br /> Dispatched by: (Signature) Date/Time Aecafvad for Laboratory by, ) Date/Time <br /> l "%- <br /> Method of Shipment: � La roto ms � f _�3 10a�� <br /> ty <br /> Special Instructions: 1 hereby auho za the formance of the above Indicated work. <br />