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(� Advanced CHAIN OF CUSTODY RECORD <br /> D�- b'-! c�� ' <br /> ---- GeoEnvironmental, Inc. 2 t;V ;za.,C �qu C . Date Page of <br /> ..✓ 4005 North Wilson Way Stockton,Calltornla-95205-(209)467-1006-Fax(209)467-1118 <br /> Client /�1A I(L)nIAL j-V-E(61 J Project Manager <br /> FIM eLjE L-Li- 122 Tests Required <br /> Phone Number e <br /> (2-6q) 46 7- 4, � <br /> Samplers: (Si nat e) `� 6" <br /> Ltd'�L � r �\� Invoice: <br /> Project Name -�rp,��L �(� E(G-1 J� D � � �� �� <br /> r 1�T ! _�_�.�i �. � �'� �cb'1�'•� AGE <br /> �. Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No, of <br /> Comp. Grab. Air Conts. <br /> F�df�Intl �= ' av j; Z 526.6 . <br /> P3 - l C, 'Ie f -1� ac lb 'og <br /> J 0 5 -Qb I X X x K - 5260 <br /> V 3z <br /> w -- I ro ' -N-6b lq'26 - <br /> , <br /> 1 r � <br /> .452-7t . . <br /> r g 45272 <br /> — <br /> fe,lmq`uis yam( ign re eceave y: ignature - <br /> c f7 <br /> Relinquished by: (Signature) Received by: (Signature) - <br /> Date/Time <br /> _ A <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) DatelTime <br /> Dispatched by: (Signature) Date/Time Revel v d for Itaboratar b 09 Patel-rime <br /> Method of Shipment: Laborat Name a(// 9 <br /> CAL �V�l~L fLxd�T �i`C14;IPBELL-. <br /> Special Ic Instruction S`/I* � Ef1Vr�31�N I hereby authorize the pe rfo mance of the above indicated work. i <br /> _ NTAINERS r �` <br />