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1 . <br /> 1 Advanced CHAIN OF CUSTODY RECORD- <br /> GeoEnvironmental, Inc. Date 03/2-4 00 Page Z of Z <br /> 4005 Norlh Wilson Way Slocklon,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client51 - �� S _ • Project Manager. <br /> A-) r <br /> f /--//,k1q C` Tests Required <br /> Phone Number <br /> Zoe 7 -Z0 0 <br /> Samplers: (Signature) Invoice: <br /> Project Namet�`�( � /�! Z.. <br /> \ ��d AGE <br /> i <br /> Cher r] <br /> Sample Location Sample Type <br /> DateLT <br /> Time <br /> Number Description Water Air Solid Contsr Notes <br /> Comp. Grab. <br /> ZDq <br /> lb <br /> 11 :0-3 <br /> �1 quis a y�(4ature) ace a y: ignalure /a��rA ele/Time <br /> PAZ <br /> Relin fished by: (Signature) Received by: (Signature) I Dele/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dale/Time Iloceived for Laboratory by: Date/Time <br /> Method of Shipment: � Laboratory Name A113AA lbiddi L Lj6< <br /> Special Instructions: I hereby authorize 16 performance o the above Indicated work. <br />