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Advanced CHAIN OF CUSTODY RECORD <br /> /J -61 <br /> GeoEnvironmental, Inc. <br /> Date! 26 Page ----L of <br /> 837 Shaw Road-Stockton, California- 95215- (209)467-1006- Fax (208)467-1118 0%1 —�S <br /> Client ProjectM�ager Tests Required <br /> P Ine N <br /> 7- <br /> Samplers (Signature) Invoice <br /> AGE Dit <br /> Project Name !p ` ,1 t � Client ❑ <br /> Sample Location Date Time Sample Type Solid No of ��� N Notes <br /> Number Description Water I Air Coats �l <br /> Camp Grab ! y <br /> 20 JZZ3 <br /> AJ -S 0�z w J 20q X ?� <br /> W: kw ILP <br /> e mgwa a ig turaReceived-by (Signature) D elTi <br /> ZG ! /6�c) <br /> Relinquished by (Sig tura) Received by (Signature) Date tme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) l , Date/Time <br /> Dispatched by (Signature) DatelTime Received for Laboratory by y Date/time <br /> WL4-may <br /> Method of Shipment1 ! Laboratory N -� <br /> f�velrv6 6Ll Cc,- lee <br /> Spacial Instructions \`„ r � �rr ! hereby authorize the performance of the above indicated work I <br /> V � 6 <br />