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� es eaartrar wf s raE� tfl� � � � fl, � � � [� l♦ <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date-Z-a--09-03- Page s of <br /> 837 Shaw Road -Stockton, California-95215- (209)467-1006- Fax (209) 467-1118 <br /> Client �J AP Project Manager 1 Tests Required <br /> Phone Number <br /> Oo <br /> Samplers (Signature) Invoice <br /> � 4 <br /> Project Name , �rS AGE�"C1r-!(.. PA,'Dr — r <br /> L�sv -- 10"-) Q�-- �� � Client ❑ <br /> Sample LocationSample Type a �� <br /> D <br /> Number Description Dae Time Water AirSoitd Cs `'l � Notes <br /> Comp Grab <br /> P/0 —2 ser 13nrf'n �1 43 <br /> 54 I Z5 FT o-09 3' 00 <br /> CJ - - <br /> i Ri 3n FT <br /> � 25 F I <br /> 1 <br /> 14 T 5 ii <br /> i , Zri I <br /> A-- s i5 <br /> e mquis e y i nature) Received by ignature Date/Time <br /> Reiinquishe y gnature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for Geld analysis 7re) Date/Time <br /> Dispatched by (Signature) Date/Time cerved f rai) story y DatelTime <br /> ioZ5 <br /> Method of Shipment Labors N me <br /> C►�? © Q r\1 G N- <br /> C�s? <br /> SpaaiallnatitutMona I hereby authorize the performance of the above indicated work <br /> l/d�j <br />