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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvronmental, Inc. Date II`7-a page __Z of Z <br /> 937 Shaw Road-Stockton, California- 95215- (209)467-1006- Fax (209) 467-1118 ! C) <br /> Client pro l linage/ 7111 Tests Required <br /> Phone Number <br /> Y6 7 le6K <br /> Samplers (Signature) Invoice <br /> AGEAK- <br /> Project Name1 AA C 4 �CJr� /� �a Client p <br /> Sample Type <br /> Sample Location Date Time Water Solid No of N Notes <br /> Number Description Comp Grab Air Conts <br /> I —A <br /> Rell uished gnature} Received by (Signature) ate/Time/ � <br /> l /tD'�`O <br /> 1d l <br /> e squished by {Signature) Recerved by (Signature) atalTrme <br /> relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Recerved for Laboratory b / Datefrime <br /> rr �.lr✓ f ) <br /> bo <br /> Method of Shipment LoName <br /> r <br /> Special Instructions %: AI hereb aute indicated work <br /> horize the performance of the abov <br />