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! ! 1• ! ! ! i i i � w w �� w r■.� � <br /> s � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> _-_ GeoEnvironmental, Inc. Date Page <br /> of <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)467-1118 06 — 134 <br /> Client Pr C- a g� Tests Required <br /> 3 <br /> Phone Number <br /> Samplers (Signature) A�` Invoice <br /> Project Name /, C"'� �tiv,� AGE3 <br /> w �� ]�/e-,5 '' xb ` Client [3 <br /> Sample Location Sample Type No of <br /> Date Time Water Solid ,��` Notes <br /> Number Description comp arab Air Conts � <br /> Mwl E a w►�, ZA 1517 <br /> ��.�:► c�./�c i� � iz.a «SS / <br /> Ai013M t..) 13A <br /> Al A / / <br /> Rel, uis e y igrrature Received y (Signature) Date/Time <br /> -2-6 -03 le-CSC <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by"bile Laboratory for field analysis (Signature) r > Y � Date/Time <br /> Dispatched by (Signature) Date/time Received for Laboratory by s Date/Time <br /> Method of Shipment Labor ry N e <br /> �2 L�--Special Instructions V I here authorize the performance of the above indicated work <br />