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�w� � s�we. �w•� ear e� ass #wl� aft! ti t: stows � � t� � <br /> i i • <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date I Stcl Page 2_ of Z- <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1006- Fax(209)467-1118 <br /> Client f� L Project Manager <br /> T. Iv-- ��' �; Tests Required <br /> Phone Number <br /> C4(,.7, ? ~oc(� <br /> Samplers (Signature) �d� �' Invoice <br /> Project Name p / AGE <br /> Client ❑ <br /> Sample Location Samplpe Date Time � Notes <br /> Number Description Water AIr Solid No <br /> /� ' <br /> Comp drab <br /> -.06, 115,01 iL33s <br /> I — Ain is e y igna re ecelva y igna(ure <br /> Date/1 ime <br /> el,nquished by (Signature) Received by {Signature) I r-��Datate(fiTrmeme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Rec or laboratory Date ime <br /> Method of Shipment � � Laboratory Name <br /> Special lnstsuctions T I hereby authors the performance of the above indicated work <br /> T <br />