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i l i l i i i l i i i 7 molt <br /> 1=11 ill <br /> 0 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> f ' <br /> - b r � <br /> " GeoEnvironmental, Inc Date Page of <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006 - Fax (209)4657-1118 <br /> Client Project Manager <br /> le P� �k �+� � Tests Required <br /> one um r 7 <br /> ��, L67-�ap� <br /> Samplers (Signature) Invoice <br /> Project Name AGE W- <br /> �� , � Client <br /> Sample Location Date Time Sample Type Water Solid No of N Notes <br /> Number Description Comp crab Air Conts <br /> :S:1t]�- <br /> v, -z bV j taq NtL�-2- XX X , <br /> -'3/ xXx <br /> W-0 ok-No - o�"Z`tX XZ I <br /> W--Vont4ll <br /> ` <br /> ef1nqqi5hpd by.( ignature) Received by ignature D lel7tme <br /> RATinclutshed b (Signature) Received by (Signature) Date[Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) ~ Date[Time <br /> t � • <br /> Dispatched by (Signature) Date/Tima Received for Laboratory by Date Ime <br /> 12 <br /> Method of Shipment r / L oratory Name <br /> c�!I- <br /> Special Instructions ( r i hereby authorize the performance of the above Indicated work <br />