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( Advanced CHAIN OF CUSTODY RECORD <br /> ---_ "� GeoEnvironmental, Inc. Date I l` ob Page of L- <br /> 4005 North Wilson Way-Stockton,Calitomia-95205 (209)467-1006-Fax(209)4671118 <br /> Client - Project Manager <br /> YG /LL Tests Required <br /> Phone Number <br /> AT>X (2 <br /> Samplers (Signature) Invoice <br /> Project Name s l/�l t1 4b � A fy AGE <br /> T Client ❑ <br /> Sample Location Sample Type <br /> Date Time Notes <br /> No of <br /> Number Description Comp Water <br /> Air Solid Conts <br /> 53281 <br /> Pq 10 2.6 r- <br /> 53282 <br /> 53283 <br /> 53284 <br /> r <br /> 53285 r-- <br /> e inquis ed by ignature) Received by S gnature DatelTime <br /> ftnquished by (Signature) Received by (Signature) Iry rDaterrinte ev' <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime Received for Laboratory by Date/Tims <br /> I <br /> Method of Shipment - L ora ory N e <br /> 01 M(- C> 2, <br /> Special Instructions t hereby authorize t re performance of the above indicarad work <br /> I � <br />