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ter <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date �g Oz Page ! of <br /> 837 Shaw Road-Stockton, California 95215 - (209) 467-1006 - Fax (209) 467-1118 <br /> Client Project M nager <br /> ,vws" Tests Required <br /> �„ CP ne Number <br /> h <br /> Sa s ( nature) Invoice <br /> i <br /> Project Name i ��a Client ❑ <br /> r <br /> Sample Location Sample Type �C. <br /> Number Description Date Time Water Air Solid Nonts �� Notes <br /> Comp Grab \ <br /> Af&J Ato,-lel-0-t- <br /> 4730 <br /> >r y <br /> ccJ <br /> -71g 6 t q-&7Z <br /> e rn s ign tua <br /> DateTrme <br /> tom. 600 <br /> Relinquished by (Signatur Received by (Signature) I Date rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Recewed for Laboratory by Date/Tim <br /> 4 N- I VA,,'J,111,' <br /> Method of Shipment jnlrr <br /> Speclal instructions I hereby au raze th p rformance of the above indicated work <br />