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Advanced <br /> i CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, 111C. Date to -4'� <br /> - page —L of Z <br /> Rf N017hN171 CCljlf(117I!(7 <br /> 1603 West March Lane,Suite A Stockton California-95207-(209)!956-0264-Fax(209)956-0700 <br /> Client { <br /> �Qr�w)4� -f- S e I y1 e 5 5 Project Manager <br /> K ��I'm M c K l b b f Tests Required <br /> Phone Number <br /> (zoq)i s6-o_.6y I i <br /> Samplers (Signature) /Invoice <br /> Project Name LI dyvroIeT -- Mad+`S0+'1 �1,�`ti`, n� {``f'�' �,��v ,<, <br /> qC � AGE <br /> h Q Client [� <br /> Sample Location Sample Type a �: Z - - <br /> Number Description Date Tlme Water Solid No of ���� Notes <br /> Comp Grab Air COntS !� ,t i <br /> -- - 5-7229- <br /> t4 W-;,/10- <br /> 57229MW-;/ro- ,q5 13,' TO _J - _ 57230 ti <br /> Mw-�/to_y-'r 5-- q-00 X X _ _ 57231 <br /> Mcv- Sllo _5 -q j3=y5 7� 3 _ X i _ __57232__ <br /> _ f <br /> 57233 _ <br /> X X - 57.234 <br /> eT� T nquis e y (Signature) h ' $7235 ' <br /> Z= cc e ( rgnalure i <br /> STand4k4 T� tU G <br /> Rclmqurshed by (Sig ture)� Recerve�by (Signature <br /> a� Y ) /, — I � r Dale/Time <br /> Helmquished by L rgna[ure eived by Mobile Laborelory for held analysis (Signalure) <br /> DatelTime <br /> Dispatched by (Signature) Oale/7rme Recurved for Laboratory by <br /> DatelTime <br /> Method of Shipment <br /> Lsboralory Name <br /> Special �f � �" `R"I--Q 1`1 e tdwt b�I <br /> pecrat 1nslruclrons �r•�• �v�- +�' <br /> il�r a ti ter _ - I hereby alllhoiize the porlormance of the above indirarnd work <br />