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( Advanced CHAIN OF CUSTODY RECORD <br /> Geo Environmental, Inc, old �� <br /> Date Page j- of�L <br /> ,! <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467- 18 <br /> Client Praje an ger . <br /> ES <br /> Tests Required <br /> P one umber <br /> Sam s: (S' nature) Invoice, <br /> Project Name AGE [ <br /> Client ❑ <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Water Air Solid Copts. Notes <br /> __ -.... . <br /> Comp. Grafi. i 1 <br /> 41 [77 <br /> 7a , tip �/ if 41378 <br /> 440 - r�o �� Okrr sC 13 7 9 <br /> '1>L 41380— ' <br /> tit 0 I ►! )0 30413 81 <br /> 1A) 4t <br /> � wl - 3-00 'I,,- 1' I " 1,;k 61 �C .41383 <br /> e i i e Receive y: ignat <br /> Re nquished by: (Signatur� �J Date/Time <br /> Relinquishedb rata = ry for field analysis:(Signature) Date/Time <br /> OFF <br /> Dispatched by;?'( `' at nlj„i i Zvi Ydi iri i�wl1J Date/Time lRecolveO for Laboratory by: dvg\", <br /> Dateffime <br /> Yt <br /> Method of Shipment: Laboratory <br /> sce Lx2pu 6:aE <br /> Special Ina uct r, I her au horize a perto mance of a above indicated work. <br /> e .� <br />