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( �Z Advanced CHAIN OF CUSTODY RECORD <br /> ----�+;' <br /> GeoEnviron mental, Inc. Date -�- ,��� Page ofd <br /> 4045 North Wilson Way Stockton,California 95205-(209)467 1006 Fax(209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name ?�IfL h nh AGE [� <br /> Client ❑ <br /> Sample LocationSample Type <br /> Date Time Water Solid Na o1 Notes <br /> Number Description Air Conts fig * <br /> Comp 4rab <br /> 0`457- I 31 .ob -}c fol? I : 33733 <br /> { 33734 <br /> 33735 <br /> + u5T 4 LD „ 33736 ; <br /> 33737 <br /> - u 6 h � ,�� 33738 <br /> 33739 ' <br /> ✓skylq LI W-tl 3 -l0- 00 16.3�� <br /> Relinquished y (Signature) ec roe y ignature 3��a� Date/Time <br /> ))�13- fro �' i IrJ' ���nur��l� 9 •'�'f`� �� . ' ' <br /> Relinquished by (Signalure) eceived by (Signature) Date/Tlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> C r� r v'Y r � 14 t� VM&GI METALS1 OTHER i-'-I - c v"'11 f v I <br /> Special InstructionsGOVU��"' rqr �� I I hereby authorize the performance of the above Indicated work <br /> Vi! �uIIIV A ,ROPRIATE r <br /> r <br /> l j�l�L�1dry(S <br /> r <br /> 0 � <br /> (ttr (XsQ0 nrS�^i <br />