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� Advanced <br /> l CHAIN OF CUSTODRECORD <br /> GeoEnvironrnental, Inc. — Date z Page --I— of _- <br /> 837 Shaw Road-Stockton,California- 95215 - (209)467-1006- Fax (209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers: (Signature) r Invoice: <br /> i <br /> Project Name AGE <br /> Client ❑ <br /> Type ype 9 <br /> Sample Coca ion SampleNo. of <br /> Number Description Date Time Water Air Solid Conts• ' Nates <br /> Comp. Grab, <br /> a <br /> 2.G <br /> 0 <br /> '82239- <br /> '_____822_4_0___.__._ <br /> 1 <br /> �0 Lao' l3 <br /> 82242 <br /> � ,hzC.o 1Wz�(G r' 13Z3 <br /> e inqu s y: (Sign re ece ve y: gnature aalel7ime <br /> tllvf_? <br /> RefingtWiWil by: (Sign urs) Received b (Signature)Y� ( g ) ri r.r- Data(Tfine <br /> Relinquished by: (Signature) Recelved by Mobile laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Re e v for tAboraf b te/Time <br /> Mathod of Shipment, l boratory Name <br /> Special Instructions: I hereby authorize IhA performance of the above Indicated work. <br /> f <br /> II <br /> I? <br />