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CHAIN OF CUSTODY-RECORD <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 M a er <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name , ��`{ � AGE <br /> Pg <br /> Sample Type r� 837fi3 <br /> Sample Loea lon Solid No of <br /> Number Description Date Time Water Air Conts <br /> Comp Grab 83764 <br /> i <br /> )d )d <br /> 83765 <br /> tr i i X x 83766 <br /> 83767 <br /> I ' <br /> e i a e y ignalure Received y (SignatureF— <br /> C R ]A- I - o <br /> Aelin4UMIWd by Signature} Received by (Signature) DatefTlms <br /> Relinquished by (Signature) Received by Mobile Laboratory for[laid analysis (Signature) DatefTime <br /> SM <br /> Dispatched by (Signature) DatefrimeIia el a or Laborator y D affime <br /> ICEII� PWIM i_ab ratory Name <br /> Method of Shipment <br /> f <br /> Special Instructions e00000 DITtUitl_ � ��r r}i�ISlplr� W --� I hereby authorize t perfo mance of the above Indicated work <br /> iu - f i_ tiT i I i y r <br />