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j Advanced CHAIN OF CUSTODY RECORD <br /> --- GeoEnvironmental, Inc. Date -j`+ -a Page _ of s <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467-1006 - Fax (209)467-1118 <br /> ClientL Project Manager <br /> e9 <br /> Tests Required <br /> ��c1_� �tc�+•l-� <br /> Phone Number <br /> C-1 p-0 J V7— 10,V <br /> f o <br /> Samplers: (Signature) Invoice: <br /> t� t�J <br /> AGEjK <br /> Project Name ��S T'qt Qc1y �i �t,•`�. 1 Client <br /> Sample Location Sample Type i r <br /> Number Description Date Time Water Solid No. of 91 t Notes <br /> p comp. crab. Air Conts. !< "k <br /> 131-4-iU - y C , ic- IHS-b 1145 X i t <br /> i3•-Lk 0—, t� � ilk X X <br /> P�zt-LO w4-C-J k 4 X <br /> Relinquished y: (Signature) ecerve y: ignature DateT1 e <br /> Relinq hed by: (Signature) Received by: (Signaiuro) DatelTime <br /> Relinquished by: (Signature) Received by Mobila Laboratory for field analysis: (Signature) S _ s� Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratorr, by: i I Date/Time <br /> Method of Shipment: oratory Name <br /> Cod � e,�n,, �t - dal . c� <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />