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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental Inc. Date �/-7�?6 Page of r <br /> -...:. <br /> of Northern California <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 5r-72,3 t='X 9a. <br /> Client Project Manager f <br /> -3!f /-f r 'JQ tJY� t Tests Required <br /> Phone Number <br /> A -(&av L <br /> Samplers: (Signature) Invoice: <br /> Project Name t 7 �b AGE k <br /> x Client EJ <br /> Sample Location Sample Type <br /> Date Time —Water Solid No. of Notes <br /> Number Description comp. crab. Air Conts. <br /> nn F <br /> l� r -tie)(P 12,0 ✓ i ,4 <br /> L <br /> Relinquished y: (Signature) a y: gnature <br /> �7 A D to/Time <br /> J�l:sAe A �/-f—. � <Z�7r7(a -J U,9 <br /> l V <br /> Relinquished by: (Signature) eceived by: (Signature) Date/Time <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 /> Meth gdt f Ship�nt: v _ Laboratory Name <br /> LII glee vcc� v�It-cC �n� /Lic- b� l <br /> Special Instructions: 1 hereby authoriz4 the performance of the above indicated work. <br /> VPP�IN IF ISIRIER <br /> H A�OiSPN� !�„�, <br />