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r r r �■■ r r r � r• I� r I� r■ r� it 3 <br /> CHAIN OF CUSTODYRECORD <br /> Advanced � <br /> _ - GeoEnvironmental, Inc. Date Page _. of <br /> 837 Shaw Road-Stockton,California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client Project Mangger <br /> Tests Required <br /> P one Number <br /> 5 lers: (Signature) invoice: <br /> Project Name AGE 0"CS X Client ❑ <br /> I <br /> Sample Location Sample Type i <br /> Date Time Water Solid No. of Notes <br /> Number Description Comp. Grab. <br /> Air Conts. <br /> 1 0 2P- •'�" <br /> C x <br /> 2-11'.9 X <br /> P- 12-'16'512 ?� <br /> e n is y: (yffhalula Ncelved by: ignature telTime <br /> R finquished by: (Sig ture) Received by: (Signature) DatefTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) DatelTime <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipme Laborat dame <br /> Special InSIMO 10nY. I hereby author he performance of the above Indicated work. <br />