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�.... „ 1■ffi s t� a• I• <br /> • <br /> Advanced CHAIN OF CUSTODRECORD <br /> -__- GeoEnvironmental, Inc. Date �� � Page <br /> 837 Shaw Road-Stockton, California-85215- (208)467-1006-Fax(209)467-1118 , 0-,9 <br /> Cherit �i� PTT YV-)i ,.e-t�7� Tests wired <br /> ne ~ WZ7 <br /> plers at I rn►ace <br /> Project Name AGE Client ❑ <br /> Sample Location Sample Tye No of <br /> Number Description Date TimeWater Air Sotto cortts, Notes <br /> Comp I Grab <br /> e i ur} y i9 a re eaerve y :gnarure DatelTime <br /> C c <br /> Relinquished by ( ure) Received by (Signature) Oate/Time <br /> Relinqu shed by (Signature) Received by Mobile Laboratory tar field analysis (Signature) 7nT <br /> Dale/Time <br /> Dispatched by (Signature) Date/Time serve or ra"by (�- Date/Time <br /> 7 Y'rm..,,,, <br /> Method of Shipment �� Labo ry dame <br /> Special InstrUCtanS Lr 1 reby ajflu`tho ze fio arformance of the above Indicated work <br /> " r - <br />