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U 10 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> _- GeoEnvironmental, Inc. Date I.;7-q Page --L otA <br /> , of Notilient Calif0nua <br /> 1803 West March lane, Suite A-Slocklon,California 95207 (209)956.0264-Fax(209)956-0700 Ci LVYIX( &E-Wl� <br /> Client C e l tv,h C e C c 4"v1 i + &i o V 4 H h o vii Project Manager Tests Required <br /> Kevitl M C r <br /> Phone Number <br /> 7�oq - <br /> 1754-01( <br /> Samplers (Signature) Invoice <br /> Project Name C�.Z y,p X-0,@ �'Y'tl C 1'1 }�O� �.� AGS {� <br /> � '� .� Client ❑ <br />� <br /> Sample Type <br /> Sample Location Solid No °t <br /> Date Time Water <br /> Number Description comp arab Air Conts <br /> 1-11471 I,0-t�5- <br /> r 3 !°'°fid ' y 1.o o X <br /> J;mfy <br /> p fwd 5, a r:� l L 1; 10 X I x X, <br /> P uti'' s. Qqd. t � = cy X <br /> r P� <br /> a inqu l a (Signature ece ve y gnature DatafTl e <br /> i <br /> Relinquished by (Signature) Rocelved by (Signature) D la(Tlme <br /> Re nquishad by (Signature) Ro ived by Mobile Laboratory lot field analysis (Signature) D te/Time <br /> t <br /> F <br /> r Dispatched by (Signature) Dare/Time flocs ved lot Laboratory by DaleJTlmo <br /> Method of Shipment / fCf�Wl �� -�- Laboratory Name r4 <br /> 1.n D Van U 7 vi�tt//lX�°� PGl�i'_n4/A_ t$ (,I�L -e I <br /> Special Instructions w-L/V �ktI hereby authorize the performance of the above Indicated work I <br /> rl <br />