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Advanced 2, CHAIN OF CUSTODY RECORD <br /> 1 <br /> GeoEnvironmental, Inc. Date Z'/;7 Page of <br /> of Northeast Califontia <br /> 1803 West March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956.0700 <br /> Client Project Manager <br /> K_-, Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name IpFAGE EJ <br /> ''►{ mit✓ � ,, Client It <br /> Sample Type � <br /> Sample Location Date Time Water Solid No. of Notes <br /> Number Description Comp. Grab. Air Conts. I <br /> V`° 60082 <br /> Div � 2, X0083 r <br /> 50064 <br /> r 80086 <br /> o � <br /> Tg S la?= j 80067 <br /> emqui y: (Signatyto) e e y: ( r re) T f,,� Date/7'mg <br /> L&A, /D: -5,6 � �b f 7S Z I -7 <br /> Re rnquished by: (Signature) (9,eceived by: (Sig ture) DateMme <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: L1� t Laborat ry Na <br /> C <br /> Special Instructions: I hereby authorize the erfo mance of the above indicated work, <br /> MA S OTHER , <br /> PRESERVATION2 � �� <br /> kvk <br /> WuLl V, <br /> HEAD SPACE ABSEfif� CONTAINERS_ <br />