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Advanced 3CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date -v5 Page �_ofS;2) <br /> 837 Shaw Road-Stockton,California-95215-(209)467-1006- Fax(209)467-1118 <br /> Client <br /> Project Manager Tests Required <br /> (�.;Sbw/c;1 v�+ i5kwa i r1 V4b,Q,,. 14%of. <br /> Phone Number <br /> &W-) 4b-1 -lSamplers: (SignatuInvoice: <br /> AGEProject Name (Jc r� S; r rn 4^ (� �- Cuero ❑Sample TypeSample Location Date Time Water SoliNotesNumber Description p. Grab. A r <br /> -b-S B ip � V� g 4-05 SSS X <br /> a-lam-1s @ <br /> C 53 X ) f� <br /> jq-7 >C 5 <br /> 135 X ( <br /> Date (� me <br /> Relinquished y: pnolure eceve Y: 1floalure 070 <br /> c <br /> Tma <br /> dinqu (Siwgna Received by: (Signature) <br /> •mqunshod by: (Signature) Received by Mobile Laboratory for field analyeb:(Signature) t�. A 'T. Date/Time <br /> DisPVcMd by: (Signature) Dale Ime Receive r orato by: (� ate(Time <br /> Method of Shipment: Laboratory Nares t <br /> Ceti Ov t(sr cA,%-Tect+ <br /> Special Instructions: I hereby authorize the,performance of the above Indicated work. <br />