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� Advanced _ <br /> CHAIN OF CUSTODAECORD <br /> " GeoEnvironmental, Inc. �J � 7 Dade Page - S7_ of <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006-Fax (209)467-1118 <br /> Client Pr � 9e Tests Required <br /> { <br /> P Number <br /> -Samplers-(Signature) Irnotce <br /> Protect Name AGE r Client ❑ <br /> Sample Location Same a Type No at <br /> Number Descnptlon Date Time Water Air Solid Corns Notes <br /> A Comp Grab <br /> a Z� ■�'� r <br /> ilk tA lidNY YIY <br /> Relinquished y ignature ecelve y rgnaturo Date line <br /> I�X23 <br /> Reiingwshed by (Signature) Received by (Signature) Datel7rme <br /> Relinquished by (Stgnature) Received by Mobile Laboratory for field anaiysra (Signature} � Datef rime <br /> Dispatched by (Signature) Dat*ffime Received for r ry atelTime <br /> 5 <br /> Methad of Shipment Laboratory Name <br /> cot <br /> $poolal Instructions 1 hereby authorize the perlwin re of t e above in ate work <br />