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Advanced CHAIN OF CUSTODY RECORD <br /> _- _- GeoEnvtronmental, Inc. 0� <br /> -/00 Date ( -A-03 Page —L of <br /> J'-.' 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax(209)487-1116 <br /> Pr ect M rte r <br /> Chant pal o�L o �c I �� Tests Required <br /> r <br /> Phone Number <br /> Sa rs (Signature) Invoice <br /> AG E E <br /> Project NameG ci's 0 Client <br /> Sample Type b`U <br /> Sample Location Date Time _ Water Solid No of Notes <br /> Number Description Air Conts <br /> Gimp Grob <br /> w►a�l of �i dD l D � / <br /> 963 <br /> ( to Y,5 <br /> 'M.�.�I dto fla3 <br /> Li Cdr I <br /> 09,16 <br /> ell ups e y ignature} ace ve y gnature ClatalTlma <br /> 6 . <br /> a inquished by (Signature) Received by (Signature) gatefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> i <br /> Dispatched by (Signature) pate[Time ecewa r boratory by s ata/Tlma <br /> Method of Shipment Lab r tart' <br /> � Nl � <br /> ance of the above indicated work <br /> Spacial Instructions �w ` "r r 6K" ! hereby uthnrize a perform <br />