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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> pate OI Page _/ _ of Z <br /> _--- GeoEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467-IUB <br /> Clienthis Project Manager Tests Required <br /> �C lv c1�� <br /> Phone Number <br /> Zo9 <br /> Samplers (Signature) Invoice <br /> AGE P�J <br /> Project Name �E 20�>~� Ck S7/� Client ❑ <br /> No of D Notes <br /> Sample Location 5amp a Type Date Time Water Solid N <br /> Number Description Date <br /> Grab Ali Conts T <br /> 70419 <br /> 4,�, y a, 70420 <br /> 70421 <br /> GYo/ l <br /> 70422 <br /> starve y ignature DateITI <br /> e inq ii, nature <br /> Dat ime <br /> Reh shed by Signature) Received by (Signature) r� <br /> Laboratory for Geld analysis (Signature} � /� � ' � DatelTime <br /> Relinquished by (signature) Received by Mobile Lab ry y <br /> Dispatched by (Signature} <br /> Date/Time Reserved for Laboratory by Date/Time <br /> Laboralo <br /> Method of Shipment ( ELL <br /> / I hereb780fl <br /> zethe per rmance of the above Indicate war <br /> Special Instructions <br /> t <br />