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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date -/0- 02- 03 Page Z- of S <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006-Fax (209)467-1118 <br /> Client V'4rJ .Di- ?o n � Project Manager —�- <br /> S�- 1 , CU e P4 P, Tests Requl;ec! <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name WE S I <br /> tj PI(' PA;Dz ` L-P ri Client <br /> Sample Location Sample Type b <br /> Date Time 9 t� <br /> Dat <br /> Number Description comWateGrab Air Salld ContS �d���� ti0` Nates <br /> D S cn1 c <br /> ,r 5 F 5�t ( ZIP-- S <br /> P-1k -::I <br /> T SA7 <br /> T 5 P7 o: 3p <br /> 1 <br /> 01 ) -� r� FT 14 , 35 X XI -�a5 <br /> r .r A-T S F 1-0 X <br /> It <br /> T 2o r I , v5 <br /> einqurs e y ignature ece ve y ignature _ OatelTime <br /> Relinquished by (Signature) Received by (Signature) / <br /> f)atalTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysra Ignature) Date/Time <br /> Dispatched by (Signature) Date/Time eeerva for Labor to by t ate/Trne�� <br /> i� ! � EU Z5, <br /> Method of Shipment C r Laboratory Name <br /> ��. 6�2�� f <br /> Special Instructions I hereby authorize the perlormance of thi atsova indicated work <br />