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t Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvi7ronmental, Inc. �j � � , ate Dace Pag$ 1of <br /> � <br /> 837 Shaw Road-Stockton, California-95215 - (209) 467-1006 - Fax (209)467: 118 <br /> Client r Project Ma"per <br /> MAE � Tests Required <br /> LK -- L dXt <br /> Phone Number- <br /> s <br /> Samplers: (Signature) Invoice- <br /> Project Name n AGE ,E3" <br /> �-" Client ❑ <br /> Sample Location sample Type Client <br /> of <br /> Number Description Date Time Water Air SolidColts Notes <br /> Comp. Grab. <br /> 4 H4 <br /> , •- �, grr --- <br /> ilk <br /> ;� <br /> e I iurs a +gna re Receivedy: rgnature atefiime ,. <br /> ff I -e axle <br /> Reli quis ed by, (Signature)' Received by: (Signature) 17atofrime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time ed for Labors ry by: Date(Time <br /> 7 <br /> ���� L <br /> Method of Shipment: Labora ory N e <br /> LOP— <br /> ecl i Instructions: I hereby author he pe o mance of the above indicated work. <br />