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CHAIN OF CUSTODRECORD <br /> t Advanced Date � 7 �`� Page C �� <br /> GeoEnvironmental, Inc <br /> 837 Shaw Road - Stockton, California- 95215- (209)467 1006- Fax (209)467-1118 03 <br /> ClientPisct <br /> Manager <br /> Tests Required <br /> P ne N tuber <br /> 4167- 1006 _ <br /> Samplers (Signature) (� Invoice <br /> AGE <br /> Project Name Client <br /> Sample Type ❑ <br /> Sample Location Date Time Solid No of Notes <br /> Number Description ComWater Air Conts <br /> LZ lln3 - 7-1-16 1�3:5 <br /> `( <br /> ( )2 XX <br /> I q X X y. <br /> A X <br /> Y X1 <br /> R 6 MjDC `7 X x <br /> M-0 <br /> e inq is e y Ig re) Receivedy ignature D telTim <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Datelrime Received for Laboratory by II dL1L� e <br /> Datefrim <br /> _ F - �y <br /> Method of Shipment k4— <br /> Lab Name <br /> c Vev t4 l (1� _ice'k <br /> Special Instructions \t, �/f I hereby authorize the performance of the above indicated worts <br /> I <br />