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CHAIN F CUSTODY RECORD - <br /> j Advanced Date 5 ` Page of_� <br /> --- GeoEnvironmental, Inc. <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006 - Fax (209) 467-1118 _ J _ 0 7& <br /> Client AL1 Project Manager ( Tests Required <br /> P one Nlum2�/' <br /> 7— <br /> amplers: (Signature) n/ Invoice: <br /> AGE <br /> Project Name " Client ❑ <br /> Sample Type (� z <br /> Sample LocationNo. of v Notes <br /> p Comp. Grab. <br /> Number Description Date Time Water Air Solid Conts. �� <br /> I-J r/C"3 0 <br /> �A <br /> 0537 <br /> elinquis e ( gnature) eceive y: ignature D te/Time <br /> Relinquished by: ( ignatur Received by: (Signature) Date/Tim <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) 7 T Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date 'me <br /> pi— <br /> Method of Shipment: � Laboratory ame <br /> Special Instructions: i( j ' // I hereby authorize the performance of the above indicated work. <br />