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( Advanced CHAIN OF CUSTODY RECORD <br /> -- GeoEnvironmental, Inc. Date Page Of <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467-1006- f=ax (209)467-1118 y - 1 <br /> 33 <br /> Client // Project Manage <br /> Tests Required <br /> t� L� <br /> ze <br /> mbar <br /> Samplers: (Signature) invoice: <br /> Project Name y� AGE D;r, <br /> Client ❑ <br /> Sample Location Sample TypeDate Time No. of <br /> Number Description Water Air Solid Conts. Notes <br /> Comp. Grab. <br /> X1 XX <br /> �1 Y, X1 <br /> W q -� e2i'7, 1( XXXI <br /> .w--�' � - X <br /> -ffe inquis a y: gnatura Received Ey: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by: (Signature) DaL11 <br /> ( (�` <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> .i 1 0.- L 1-Ntil "1 <br /> Method of Shipment: L Laborator ame <br /> -Ll lfr'C 'T CC L <br /> Special Instructions: kkr{ �^ / I hereby authorize the performance of the above indicated work. <br />