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CHAiN OF CUSTOD 'jECORD <br /> ( Advanced r <br /> r <br /> GeoEnvironmental, InC. Gyl Dat� 6 page °r <br /> 837 Shaw Road - Stockton,California-95215- (209)467-1006- Fax (249)467-1118 <br /> Client Pro'e nag <br /> � lir Tests Required <br /> P e Number <br /> Sam : (Signature) Invoice: <br /> �, <br /> Project Name �`�"' AGE E]Client ❑ <br /> Sample location Sample Type No..of <br /> Number Description Date Time Water Solid Notes <br /> Comp. Grab,70 X3/o 1 1056 3K— Air {�iofltS. t <br /> 'If <br /> 7355 i <br /> -1 75 10 k C <br /> If <br /> `r► "" - G/ !� l ` k , .._:.,._ 73.5.0....... ... ,r <br /> _ nQ ,r <br /> 7.3508 � <br /> ! 1 <br /> f <br /> i4 V%-ffr <br /> e Engws a y:k i a- r ate/T e <br /> t7 <br /> Aelinquished by: �5yy/��i(�����py}� ��7fa _(/ y ecelve D e/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laporatorr jby/: 13�77(;I` <br /> 61004 <br /> Method of Shipment: Laboratory N me f <br /> 0,,A y/7� <br /> Special Instructions: 1 hereby authorize the p rtorman a of the above indicated work. <br />