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r r r cc rr r r CA r r r r r r r �� � r � <br /> Advanced <br /> GeoEnvironmental, Inc. CHAIN OF CUSTODY RECORD <br /> of Noi-lhetn California Date �'¢ Rage �^ of� <br /> �S Y• �,,� IW3 West March Lane,Suite A.Stockton.Califomia-(209)9560264 <br /> Client qy, r Project Manager <br /> 8D� MQH� Tests Required . <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name A rt `F r�;STS �^c� ey AGE N <br /> I h Client ❑ <br /> Type Typ <br /> Sample Location SampleNo. of <br /> Number Description Date Time Water Solid qZ` Notes <br /> Comp. Grab. Air Conts. x, t <br /> —I <br /> 6:Ll y X 7- <br /> M <br /> M w-Ii/q; —q 16;35-1 2t- K <br /> row-S/L447-4� <br /> 1i Lv <br /> Relinquished by: (Signature) �.dgn u e pate/Ti e <br /> 4-Z7-t� 7��+`i <br /> Relinquished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date(Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> A kd <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />