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r77 r-7 r7 <br /> r--r ft""`"�. <br /> Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. .7®Q Date Q-,N, -G i pageOf <br /> C 1 <br /> 837 Shaw Road - Stockton, California-95215- (209)467-1006- Fax (2Y9) 467-1118 <br /> Client Project Manager <br /> rTests Required <br /> r wi r✓e-� r- <br /> Phone Number <br /> Samplers: (Signature) y <br /> � Invoice: <br /> Project Name ,y'�l`' D AGE <br /> I � <br /> a S}� L Client ❑ <br /> Sample Location Sample pe (� <br /> Number Description Date Time Water Solid No, of <br /> OF, Notes <br /> Comp. Grab. Air Cants. � ,: <br /> a7-ata-c,, 0037 X 3 - -73.5-19 <br /> II <br /> '- tie 7- 76 67-11- OgOA >( `- 73.52 .. <br /> k � <br /> _ 1d / !-.6s <br /> o�-��..-�� C�� 33 � 3 ,.._....- 7352._ ... . <br /> I.lz 45:.s Ll7 X ti - _7.3.5.2 - <br /> -IrZ <br /> 67l JLY16- 3 7:352.3. <br /> 74 -'79 <br /> r5 <br /> -12 All - 9y 07-At,-t,, 73525 ; <br /> e m e i4gnature ece ve y: rgnature ^ <br /> Date/Time <br /> RelWF medy' i nature) Received by: (Signature) � 1�1x ✓ �0 <br /> Date/Time <br /> Relinquished by: (Slgnature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Dat./Time <br /> Dispatched by: (Signature) Date[Time Received for aboratory by; <br /> D telTime <br /> Y--w/- <br /> Method of Shipment: q �y aboratoorName <br /> ICi>"1}® ��7Ef�Yi1O1"?C. C�LiM <br /> Special Instructions: COND I110�� <br /> I hereby authorize the performance of the above indicated work. <br /> H1;kD SPA.,E X- E,'1T C01•d�AINERS <br />