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Advanced CHAIN OF CUSTODY RECORD <br /> � azPage �_ �...�.._ <br /> - ,"- GeoEnvironmentai, Inc. 0,12166:61,/& Date <br /> I 837 Shaw Road- Stockton,California-95215-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Reg it <br /> pd <br /> vL E uL <br /> Phone Number <br /> Sam rs- (Signature) lrtvolce <br /> Project Name ,/ AGE El <br /> L� clreM p <br /> Samp a-Type Sample Location Date Time Water Air Solid s f%) <br /> Number Description Date Notes <br /> Comp (arab <br /> ! <br /> -�00"A&YelDe.' to /d oz <br /> afingws y (Si gn re , ece v y (Signature) <br /> hr 4 Mtn - DatefT me <br /> �•_ _ _ <br /> /441) <br /> Relinqh9had by QW911atuivi '", c-#�Rtd y Mnatur F� ��" �� Dalerfima <br /> Relinquished by (Signature) Received by a Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (SLgnature) DatefTime Re i for Labqratory atefTime <br /> Method of ShipmentLabo ry Name <br /> 4J ALL <br /> Special Instrucifons t hereby a orize the performance of the above Indicated work <br /> a <br />