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l <br /> Advanced CHAIN 9F PUSTODY RECORD <br /> GeoEnvironmental, Inc. Date gage ot� <br /> 0 637 Shaw Road - Stockton, California- 95215 - (208)467-1006 - Fax (209) 467 1118 <br /> Client Project inager <br /> 0 /'aA Tests Required <br /> P ne umber <br /> SarsS gnatur ) Invoice <br /> Project Name AGE E?/ <br /> Client ❑ <br /> Sample Location Sample TypeDate Time Solid No of Notes <br /> Number Description Water Air Conts <br /> Comp arab <br /> F 13 W) <br /> WAS 1 O rymn <br /> ICGR'�., VATI N <br /> GOOD(7QND1"flOX w PRQPRIA'I <br /> HEADSUCRABSM <br /> DRCBLORINATEDINLAB- PRESER1JEf3 N LAP_ <br /> die iI <br /> u e y ig atur Received y (Signature) <br /> eta/Time <br /> 1 51730 <br /> Relin uiehed by (Signature) Received by (Signature) Date(Time <br /> Relinquished by {Signature) Received by Mobile Laboratory for field analysis (9ignature) DatelTims <br /> Dispatched by (algnature) Date/Time Race ved for L boratory by Date(Time <br /> . D <br /> Method of Shipment Laborator Nam <br /> O-A <br /> Special Instructions 1 hereby thorize t Oerformance of the above Indicated work <br />