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r r r E r r r r r r r r r r r r <br /> r <br /> t� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnyironmental, Inc. Date " Page - of--�L_ <br /> :.::. <br /> 4005 North Wilson Way-Stockton,California-95205-(249)467-1006-Fax(209)467-1118 <br /> ClientProject Manager <br /> Tests Required <br /> Erioti <br /> Phone Number <br /> the <br /> Samplers: (Signature) Invoice: <br /> Project Name zllel� AGE"JK <br /> Client ❑ <br /> Sample Location Date Time Sample TypeWater Solid No. of �� Notes <br /> Number Description Air Conts. <br /> Comp, Grab. <br /> 42952 ;- <br /> 429 }- <br /> r r <br /> 42954 <br /> -27 -X t <br /> .T 1 42955 <br /> Py 4295 <br /> 4295 ' <br /> e inqurs a y: rgnature) eca ve y: S brie ure <br /> 3T D ifrr 42958 <br /> Relinquished by: (Signature) Received by: (Signature) .... r <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for ab rat ry by: ..1/ QatelTime <br /> I <br /> Method of Shipment: ye <br /> 1 .Name <br /> coP. C7Ca,n)e1� <br /> Special Instructions: 17T, I hereby authorize the performance of the above Indicated work. <br /> 0 �v <br />