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• • �n _ 08( <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page 'Z o� <br /> 937 Shaw Road-Stockton, California-95215-(249)467-1046- Fax 1209)467-1118 <br /> Client Project Manager Tests Required <br /> q V-& v"Joe, �. <br /> `S "WA4A Phone tNumber <br /> b � <br /> Samplers (Si ature) Invoice, <br /> 4 <br /> AGE <br /> Protect Name Client p <br /> Sample t ocatlon Sample Type No of <br /> Number Description Date Time Water Air <br /> S°ltd Conts Notes <br /> Comp Grab <br /> LZZ.- <br /> 1� 7 9-7t� t( 4 <br /> X C <br /> l t 4 11 0 �C <br /> �f i <br /> TR.linCqu..=h,dby <br /> eceive y Rgnature Date[Time <br /> OZ r100 <br /> (Signature) Received by (Signature) DatelT4me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) �.r--,� T Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by 1 Date/Time <br /> Method of Shipment Laboratory Name <br /> V nI v- f- c <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />