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Advanced CHAIN OF CUSTODY RECORD ; <br /> - GeoEnvironmental, Inc. Date 6-X9- g t Page of <br /> =' of Northern California <br /> 11303 West March Lane,Suite A-Stockton California-95207-(209)956-0264 Fax(209)956-0700 y �- <br /> ' Client �ctr `vVtnn '� 50'11'45 Project Manager <br /> dab IKgr~'� Tests Required <br /> Phone Number <br /> (;Loq) q5-6-0-6 0 4�a <br /> I Samplers (Signature) �a ���1C o�p� ,�hp'' Invoice <br /> ProlectName (,r%iQS� (-AtvroJ-e7- - 1'' adl501 � 7 �' 'Yao AGE <br /> ; Client [� <br /> NumSample of <br /> Date Time <br /> Location Sample Type No �� �� <br /> Number Description Water Solid �y y Notes <br /> Comp Orab Alt COntS, <br /> 53010 <br /> (7 P ( )-0 �'qt�14 x �. �,y � 6-It-Q h1 1630 � Z__J_ x X X x X � I <br /> r (,P». - 15-- 6-zeVs T � ly� X X X X. X X 53017 i <br /> 2 x X x X X i 53© 78 <br /> r <br /> (7P 1z -�-y�` ,t �I -3 y753019 X x X X 53619 <br /> V 13 —1Z0 5I`i-wit1K E e1 TtIY-11'1 I L ' 140 53820 <br /> 6P13 �zy <br /> 53611 <br /> P15, -15' lvo1nw-iiweYMw,y 16.00 �( X ; 53022 <br /> Y e in uis 9 I <br /> q y ipnatiye - /��' i <br /> ltf,,/fj�/(t' y ign "e...K.i.� <br /> /V.-eO AXl 5�andQ1 '_ ,r Dateffime <br /> Relinquished by ( ignatuie) G'3 - 5 6'�Q`Y tt(.f78 <br /> cawed by (Signature) Datefrime <br /> FRelinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) <br /> Date/Time <br /> G Dispatched by (Signature) Dale/Time fiecoived for Laboratory by <br /> Dale/Time <br /> J Aelhod of Shpmen'ethod of Shtpmeni Laboratory Name <br /> Spacial Instructio s _ I hereby authorize the performance of the above Indicated work <br /> 1' t <br /> 1i*'-7A9SPAuE ksS&Gt ftmgm-w- <br />