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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental Inc. Date 9.Qzl z Page of <br /> of Nnrflfem C(difon tirr <br /> 1803 West March Lane, Suite A-Stockton. California•95207-(209)956-0264-Fax(209)956-0700 <br /> Client Project Manager <br /> tz, Tests Required <br /> Phone Number <br /> Samplers: (Signature) // Invoice: <br /> Project NameZVA�L� <br /> / AGE Z <br /> !1 / �` / Client E]Sam le Type �� / <br /> Sample Location P yP o <br /> Date Time <br /> No. f <br /> Water <br /> Number Description Air Conts. �j , �---� <br /> ComWSolid Notesp. GrAb. � <br /> rv3� 11-2 , 69445 <br /> - — <br /> °a 69446 j <br /> i- - b 11''s ✓ �( 69447 <br /> A K '69448 <br /> 9 4 4 8 <br /> t , <br /> einau y: ( ,gnatexey; ( r ire) ��25_�� Date/Time <br /> G�7r ' Ja•3d 4 7 ? 9- <br /> Relinquished by: (Signature) 7c.�d by: (Si ature) DatelTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Melhnd of Shipm nt: Laboratory me <br /> Special Insituctfons: I hereby autho ize the performance of the above Indicated work. <br /> Mr <br /> MW all. <br /> it U i'):11�klrll, WrMit <br /> ""1�'F ABSENT <br />