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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc date 3 Pae of <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006 - Fax (209)487-1119 <br /> Client � ..,,� / Project Mana er <br /> 4, � � � Tests Requfrea <br /> nr <br /> '"$ f ��, Phone Number <br /> Sampl rs (Signature) Invoice <br /> Project NameC / Q AGE Client ❑ <br /> x a <br /> Sari ple Type , ~ <br /> Sample Location pate TimeWater Solid No of Notes <br /> Number Description <br /> ��, , ' �y� <br /> p comp (arab Air Conts <br /> A y 3 <br /> -03- A4 car <br /> 40 t1 6-50a e,3 XA LJ 4) <br /> /Z <br /> a,t�&-�3 �w /z <br /> e an e y nature ece ver y gnature Date/Time <br /> 11130 02!��e <br /> Re quashed y (Signature) Received (Signature) Date rime <br /> I <br /> Relinquish !Home I <br /> 1W(Sig ure) Ate Rby nklip I&n&AJj&4r field analysis (Signature) Date(Time <br /> Icon00 <br /> rrr�� 't� ` mac <br /> Dispatched Wt DatelfimeMwrLaboratoryby�. D te/Time <br /> /2-ov <br /> Method of shipment Labo► tory N ` <br /> S eci i Instruchoop i hereby uthorize t e performance of the above Indicated work <br />