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• CHAIN OF CUSTOD RECORD <br /> � Advancedr/ <br /> Date o_� Page J Qf <br /> GeoEnvironmentai, Inc, j} <br /> 837 Shaw Road- Stockton, California-95215- (249) 467-1006 - Fax (209)467-1118 <br /> Client t ProP Man ge Tests Required <br /> 1f �t P one Number <br /> Sa ers ignature) Invoice <br /> AGI= <br /> Project Name Client ❑ <br /> Sample Location Sample Type No of <br /> p LDalTime Water Solid Nates <br /> Number Description Air Cants <br /> Comp Grab <br /> 'L <br /> a Z'L0 �a <br /> to imp <br /> e in ro <br /> ui e y (Si nat re) Received gn a p8P.4) tVA•FfoN a <br /> GOOD COPiD1'TIt]N APPROPRIATE <br /> Relinquished by (Signature) Received IIVLA .�PUMVEDIN galelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysts (Signature) �� DatelTime <br /> Dispatched by (Signature) Date[Time Rec i or Labotatory b to/Time <br /> Laborato a <br /> Method of Shipment <br /> I hereby au rize`lhe rf mance of the above indicated work <br /> Special Instructions { <br />