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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnv>ironmental, Inc Date o age —L- of <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006 - Fax (209) 467.1118 C,t _ 4 <br /> Client Project Mana r Tests Required <br /> WZ GcE�f�i� <br /> P one mber <br /> Samplers (Signature) a Invoice <br /> Project Name AGE , <br /> 1 /� {C r tri f� _; � `��' Client ❑ <br /> Sample Location Date Time Sample TypeSolidNo of <br /> Number Description Water Air Conts //,,,, Notes <br /> Comp Grab wJ <br /> Q400 v LJ D cr lt)-?3n <br /> X— t <br /> arc �.z�J �C g�� � � <br /> % qA <br /> w 5C <br /> K13 <br /> e inquis e 1 ature) Received by ignature ateTri e <br /> b r eE) <br /> Retmn wished by (Signature) Received by (Signature) Date ime <br /> Relinquished by (Signature) Received by Mobite Laboratory for field analysts (Signature) 1ATt , Dale/Time <br /> � <br /> Dispatched by (Signature) DatetTime Received for laboratory by Date/Time <br /> ylt-01 I1 nr <br /> Method of Shipment Labo ory Blame <br /> �� t CZ <br /> Special Instructions r 1 hereby authorize the performance of the above indicated work <br />