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Advanced CHAIN OF CUSTODY RECORD <br /> � <br /> --� GeoEnvironmental, Inc. -quo W-u-) �,� Date gas of� <br /> 837 Shaw Road - Stockton, California- 86215 (21G)467-1006 Fax (208) 467-1118 _ <br /> Client Plett an ger Tests Required <br /> Phone Number <br /> 5 <br /> Samplers {Signature} r Invoice <br /> AGS <br /> Project Name �j #, �} �(� / xClient ❑ <br /> C_i�Ct WlCt �Se�vl , w� <br /> Sample Type r .t� <br /> Sample Location No of <br /> Number Description Date Time Water Air <br /> Sofld Conts _ <br /> k' <br /> -�44- I I <br /> 'PWt �= t24 <br /> ! <br /> 4A <br /> tt <br /> AssFr's Kik r E3 <br /> f1 JJ� w y 'ei r g <br /> +t' <br /> i <br /> t <br /> n h� rr9764 <br /> - <br /> lLiy..blia`i M <br /> el n uda Y 9natu e) aceive y ign ure )I J�� <br /> �- , I-e c <br /> e FnA4�deharf � (�e�g� red Received by (Signature) Dale/7tme <br /> FC�f14+` Es ttfq <br /> uish by (S3gnalure} P(7rrr�+ eTF� ! i Recbl ed by Mobile Laboratory for heid analysis (Signature) OatalTima <br /> er <br /> � <br /> �� pate/Tima Received for Laboratory by pate(Tinya <br /> Dispalah �y (SI <br /> ti arm$r (�! Y ' - <br /> V4 11NJ...i = <br /> irvrin, yw„J� <br /> c-e hod of Shipment Lahoralc y arae <br /> I ! hereby aut a J the Q rformt'anni/ce of the abova indicated work <br /> Spacial Instructions '} <br /> L 4e S Y(-S- <br /> t <br /> (- - �\ <br />