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0 0 / <br /> � <br /> { Advanced CHAIN OF CUSTODY RECORD <br /> g <br /> --- ,%' GeoEnvironmental, Inc. Date I 0-3t-03 Page Z- of z- <br /> 837 Shaw Road Stockton, California- 95215- (209)487-1008- Fax (209) 487-1118 <br /> Client M Q)P M k I Project Manager j Tests Required <br /> Phone Number <br /> 4G,77 100C4 <br /> Samplers: {Signature} Invoice: <br /> Project Name j� P �.�0 AGE ,� <br /> M 7 r Nov r 1 9 >f Client 0 <br /> V <br /> Sample Location Sample Type No, of <br /> Number Description Date Time Water Air Solid Conts, �La Notes <br /> P. Grab, <br /> N pi 145 if 03 MW B' /a-31-o 3 17-60 ly <br /> e i quis a y: ignature) - Received y: (Signature) <br /> Date/Time <br /> - <br /> 5-,03 I <br /> Relinquished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) � 1 � Date/Time <br /> Dispatched by: (Signature) Date/Time lRecel e to Labor ory by: Date ime <br /> f � bF t7 � t:e <br /> Method of Shipment: Labgrato�y NPe <br /> Special Instructions: �� I hereby authorize the performance of the above Indicated work. <br />