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,960 E.Gilman Street GEOTEST <br /> - Long Beach,90815 PROJECT NO <br /> "Romp, Telephone:(310)498-9515 (800)624-5744 CHAIN-OF-CUSTODY RECORD <br /> Fax:(310)597-0786L DATE PAGE OF <br /> PROJECT NAME u6vr6,-^ iPev&v.%e_ METHODS SPECIAL HANDLING <br /> ADDRESS 4i1 0 "r C' aw <br /> SAMPLER'S SIGNATUR - cc <br /> Z z <br /> PRINTED NAME JO w p w <br /> CLIENT PROJECT NO. Sgt— 5'-rOcl`i a i w NO x Z p <br /> PROJECT MANAGER �tyicQ `f3¢an (7 x oC FQ- U <br /> LL <br /> c6_ <br /> SAMPLE NO. DATE TIME LOCATION 0 0 <br /> i <br /> X <br /> �w'�3 loZs 2 -2/, s <br /> RELINOUI HED BY DATE ELINQUISHED BY DATE RELINQUISHED BY DATEIII SAMPLE CONDITIONS <br /> RECEIVED ON ICE */No O <br /> SIGN TURE �/ SI NATURE 2Iv q SIGNATURE <br /> r �I CHAIN OF CUSTODY SEAL <br /> (� �� 4 <br /> PRINTEgg-NNAME TIME PRINTED NAME TIME PRINT AME TIME PROJECT COMMENTS <br /> 1-IS 1 <br /> COMPANY '�� COMPANY ' �jv COMPANY <br /> R CEIVED BY DATERECEIVED BY DATE I- <br /> (XV <br /> (,VED BY(LAB DATE <br /> SIGNATURE 2Z'/� SIGNATURE ATURE <br /> PRINTED NAME TIME PRINTED N TIME PfMTEDNAME TIME <br /> COMPANY -30 COMPANY COMPANY <br /> nnirinln� <br />