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Advanced CHAIN OF CUSTODY RECORD <br /> I837GeoEnvironmental, Inc Date o " l Fria _—Jof-4- <br /> 837 <br /> Shaw Road Stockton California 95215 (209) 467 1006 Fax (209) 467 1118 <br /> :CIje:nt ProsManager <br /> Tuts Required <br /> one Number 00 <br /> a I's gnatufre) invoice <br /> Project Name AGE ❑ <br /> Client <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time WaterAir Solid C of Notes <br /> Jy/ Comp Grab <br /> e in I i nat re) ecesve y +gnature pato/T+ e� <br /> l � <br /> Rel+n u+shed by ( ignatur Received by (S+gnalure) � E7atalTime <br /> Relinquished by (Signature) Received by Mobile laboratory for held at+aiysis (Signettue) t3alelTrme <br /> C2 Ni <br /> Dispatched by (Signature) Dale/Time Rocelvsd for i aboratory by [3ate/iima <br /> Method of Shipment A aborator G� <br /> ` _ <br /> Speolal inskttctrons 0.:c <br /> 600D600D CDNDITr(1N��''` APPROPItIA hereby hot+z the etformance of its* above indicated work <br /> A'I��� <br /> HEAD SPACE ABSEI^T _� CoN rAINEIi.S I <br /> DECIIRECD SEALED&INTACT VIA VOAS IN � tWALS I OniEe t` r <br /> BSE <br />