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Advanced CHAIN OF CUSTODY RECORD <br /> j (� o <br /> GeoEnvironmental, Inc. V Date�— Page ori <br /> 837 Shaw Road-Stockton,California-95215- (209)467-1006-Fax (209)467.1118 <br /> Client ProjectManager � ` 1 ' Tests Required <br /> tom€lazY�l- J" ,,C--u <br /> Phone Number <br /> (loci) <br /> i) <br /> Samplers: (Signature) Invoice: <br /> AGE 0 <br /> Project Name � � � Sias fc� ` client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No.of y Notes <br /> Number Description Comp. Grab. Air Carts. <br /> -B-q-S g-q @ s' 6�}'�`� 1123 <br /> Ior 1131 7� t Ilt� <br /> it If <br /> It It fvr ta53 x 1U,� <br /> 1, it ZS' t5z5 k ' 1 <br /> A—O} 1yVA�S �Gc� .�avvt `$•`{ 1SZF � 5 /` <br /> Relinquished Y (signature) ace -e Y: rgnatun DaleRl e <br /> flelinquish by: (Signature)' Received by: (Signature) Dab ime <br /> Relinquished by: (Signature) Meceivad by Moblb Laboratory for field analyaie: Slgnabrm) S �•T Delen'ime <br /> Dispatched by: (Signature) Daternina Recede it f r +tory by: ab/Time <br /> Method of Shipment: Laboratory Mama <br /> Clik L iCC t+ <br /> Spedai Instructions: I hereby authorize the performance of the above Indicated work. <br /> v <br />