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CHAIN OF CUSTODY ECORD <br /> t <br /> Advanced <br /> GeoEnvlronmental, Inc. Date _1�-' Page � of � <br /> 837 Shaw Road - Stockton, California-95215-(249)487-1008- Fax{209)467-1118 02, <br /> Client ,C <br /> Project Manager Tests Required <br /> G)!)�Lp— --X- _ Phonp Number <br /> Samplers Signature) Invoice <br /> AGE <br /> Project Name Client ❑ <br /> Sample <br /> Sample Loca ion Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> i <br /> 70 P l� <br /> �► 35 41 il Ifl I <br /> M03 WOD3 44-3 125� <br /> P3 V-)- L/ 13 17 <br /> e t y ignature) Ra ve y atu►e �� Date/Timis <br /> R uishad by (Signature) Received by (Signature) Dalel7ima <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Daterrime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by� Datefri e <br /> Method of Shipment La tory Name <br /> o .(I <br /> Special Instructions i hereby authorize the performance of the above indicated work <br />