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40 0 <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> "- GeoEn�xronmental, Inc. <br /> Date 63 Page - of 7 <br /> 837 Shaw Road- Stockton, California 95215-(209) 467-1006 - Fax (209)467-1118 Q /J <br /> Client Prole anager <br /> Tests Required <br /> Phone c` i�. q 67 <br /> � <br /> Samplers (Signature) Irnrolce. <br /> Project Name I V Q AGEr <br /> 1 " � Client r <br /> Sample Location Sample Type Solid No of ' <br /> Number Description Date Time Water <br /> Comp arab Air Conts Notes <br /> tyJQ B S6 i <br /> Y Ob <br /> I <br /> Q tl V C� 1 <br /> lc m D� 1 <br /> e inqu s e y (Signature eca ve y igna(ure DatafTim <br /> Relinquls d by (Signature) f Received by (Signature) "'"'rJ Datefri a <br /> Relinqu shed by (Signature) Received by Moa Laboratory for to analysis gnature) ll JJ Date(Time <br /> piapalchsd by (Signature) Date/Time Recs ved for Laboratory y QK �, Datefrime <br /> Method of Shipment Labors <br /> Special Instructions I hereby authorise the performanoe of the abo a Indicated work <br /> i <br /> I <br />