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a <br /> j� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> Date b 'R -()r;7 Page <br /> _ GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton.California-95215- (209)467-1006-Fax (209)467.1118 <br /> Client ,b�� (�:F tc�L�.�14i 1` P j � Tests Required <br /> k-alo �-' <br /> Phone Number <br /> C2�'t) <br /> Samplers: (Signature) lrrvoice; <br /> AGE <br /> Project Name Nj eA <br /> e,;- vk- �J <br /> Client ❑ <br /> Sample Location SanDate Time Water a YPe Solid No. of / Nates <br /> Number Description camp. crab. Air Cords. <br /> g-i.S--iS Ic ' C't1Z__ X <br /> r, Qs_I I< C 4060 <br /> B -�+�- is .1 1�r �•{ � X <br /> oj48 "lc� <br /> eingws y: ignstute Rricaivinl by: ignalwe Dab Wins <br /> lin ished by: (Signature) Received by: (Signature) Dab Ime <br /> Relinquished by: (signatwe) Received by Mobile Laboratory for field snalys •(Signature) G 1- 'l T• Dat•/yfine <br /> Dispatched by: (Signature). Dau Ime • Do ate/Tim• <br /> Method of Shipment: Laboratory Nam• <br /> special instructions: 1 hereby authorize the performannc.Je�of the above Indicated work. <br />