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CHAIN OF CUSTODAECORD <br /> � Advanced Date I� G page —J— of �– <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road Stockton, California- 95215- (209)467 1006- Fax (209) 467-1118 05 —/00 <br /> Client Proj��M C a e Tests Regw—'Peylpir <br /> Phone Number <br /> Samplers (Signature) u 1� Invoice <br /> Q <br /> AGE <br /> Project Name .[J Client ❑ <br /> Sample Location Date Time Sample Type Solid No of Notes <br /> Number Description War Air Conts <br /> Comp Grab <br /> sllelc-5 13C6 X"" Cl) <br /> -14 <br /> E-6, �2 <br /> AIN),? �-O 1 <br /> eL uis edby (Signature) Received by (Signature) Date(Time <br /> Relinquished by (Signatur Received by (Signature) + nate rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) DalelTime Received r ab ratory,by Date[Time <br /> s rr os <br /> Method of Shipment,, pp � Laboratory Mame <br /> �C-4k10 — I k—�> <br /> Special Instructio s I hereby authorize the performance of the above Indicated work <br /> �� s — �u L / � rte► �� <br /> l <br />