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ttttttttt� � r ■ � � it t� � �� ■�w� �� � w�f �� � a� <br /> Advanced CHAIN OF CUSTODYy RECORD <br /> GeoEnvironmental, Inc. <br /> Date '7'31 -6,2_. Page ! Of <br /> 837 Shaw Road 1151ockton, California-95215-(209)467-1006- Fax (209)467-1118 <br /> Clien��-Ns(L4 ra Project Manager Tests Required <br /> i <br /> Phone Number <br /> `1 CO - l6d <br /> Sampl rs (Signature) Invoice <br /> ,� � rrAGE <br /> Project Name PCS-C4 t C '`�G.►� 1. i r '�� v Client ❑ <br /> Sample Location Date Time Water Sampl yPe Solid � <br /> No of ,, :J Nq 0� c NotesNumber Description comp (arab Air Conts k 4 <br /> M1.1t7a �t �i �4f�d�� -�a' � �3t�� c I�ft / �a� p " 5 <br /> w1 � 75 ` � r ' `` ` --35 <br /> w -16 �+ tr r+ ��r � �S � �`• X <br /> pr r <br /> it J r <br /> e mquis by ure Received By '(Signature) J,/ I DatelTrme <br /> �.� <br /> Relinquished by (Signa ure) Received by (Signature) DatelTrme <br /> Relinquished by (Signature) Receivad by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime a for Laboratory by b�! pate rme <br /> Method of Shipment oratory Nam i t`1x0.1 FVy��,j�l <br /> ♦ � tom( i !C Aix ! f Ga,[ <br /> Special instructions { } f I hereby uthorize the parfo mance of the above indicated work <br /> 0A)-4A^06,u 60 ns tw;�1Do 1?n AmI t boo w <br /> IF n o.. 250 SA-O lt-5 a no/ -t <br /> S4AW/@ <br />