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f <br /> Advanced CHAIN OF CUSTODY RECORD <br /> W. GeoEnvironmentai Inc. Date �� Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fay(209)467-1118 <br /> Client / Project Manager <br /> p � Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name �� AGE <br /> PAW, 1.1) VRIQI�l Client'❑ <br /> Sample Type <br /> Sample Vocation Date of <br /> Number Description Date Time Water Solid Notes <br /> P Comp. Grab. Alr Cortts. i f <br /> AdJf 69985 <br /> X99.8® <br /> fit- <br /> 1'.­_ 6998:9. fL <br /> I I' <br /> linq_l ishea aturs Receivea by: gnaturs Date/Time <br /> l v i l <br /> Relinquished by-.-( ign ure) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time I ReceiveA for Laboratory b ate/Time <br /> l2� � r c <br /> Method of Shipment: VOAS Qauie;;'Fii LS OTHER Labors, Name <br /> a Q�LV' �/ I <br /> Special Instructions: GGOD CONDITION APPROPRIATE I hereby authorize the performance of the above indicated work. <br />