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j AdvancedCHAIN OF CUSTODY RECORD <br /> GeoEnvironmenfal, Inc.. 0 42-G3� Date page of , <br /> 837 Shaw Road' - Stockton , California = 95215 '(209) 467-1006 - Fax (209)-467- 1118 <br /> Project ct Mana <br /> Client I _ _ _ , L Tests Required' <br /> P one NUer 7 � <br /> z.c.�r 4 -L <br /> eJ <br /> Sa (ers: (Signature) �/l , Invoice: <br /> j AGE <br /> Project Nam client <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts. Notes <br /> rr comp. arab. <br /> LLa <br /> Irif 1� <br /> LAO <br /> J <br /> OL <br /> linri)Zed signa Reodived by: (Signature) Date/TITe <br /> i _ C1�fZG�J l ( l9�fJ <br /> Relinquished by: (Signature) . ttecefved by: (Signature) Deteirrime <br /> Relinquished:by: (Stgnature) Reoeived by Mobile Laboratory for field analysis: (Signature). k n Date/Time <br /> Dispatched by (Signature) Datomme Re" a . <br /> for lab awry bb�v' •�/ atejl'ime <br /> 27 <br /> Method of Shipment'. ..oratory Name <br /> Special instructions: I he Y thoriz'e the erfon of the above:'indicated work. <br />