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Advanced CHAIN OF CUSTODY RECORD <br /> Date Page .--F--- of—�— <br /> GeoEnvironmental, Inc 051 Cl <br /> 837 Shaw Road- Stockton, California - 95215- (209) 467-1008- Fax(209)467-1118 <br /> Project Manager <br /> Client C " > Tests Required <br /> Phone Numper <br /> e7 <br /> am Samplers (Signature) y Invoice <br /> r r X AGE <br /> Project Name a� r i3eL Client <br /> ] <br /> Sample Location Sample Type No of Notes <br /> Comp Grab <br /> Number Description Date Time Water Air Sold Cotes <br /> L <br /> squished by S lure) Rece+ved y -(Signature) Datefrime <br /> 6Z <br /> quashed by (Signature) Received by (Signature) D teff+ e <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) GatelTime <br /> Dispatched by (Signature) Date/Time Receive for Labgratory D e(Time <br /> o pZ $•<d <br /> Method of Shipment Labofaftllry Name A <br /> Spemimlnsu�ctwns / � 16i�._, r�� f hereby authorize the erformance of the above indicated work � <br /> PRESERVATION G,+� <br /> FTE <br /> F,D SP?.CE r1usE,4TE <br /> T CONTAINERS <br /> DLI Q=RINATED IN LAB <br />