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0 s s <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 12 �Page CeA of <br /> of Northern Cahfonua <br /> 1903 West March Lanv Suite A Stockton California-95207-(209)956-0264 Fax(209)956-0700 <br /> Client Project Manager <br /> qn f 5C CVS�f�l Tests Required <br /> Phone Number <br /> Zc,CC( S� -<], <br /> Samplers (Signature) Invoice <br /> Project Name J S AGF— <br /> Client <br /> Sample Location Date Time Sameple Type Solid No of Notes <br /> Number Description WatComp Grab Air Conts <br /> fLvr <br /> l ] � o lL5 <br /> 2 t+ 0 ZrJ <br /> 2 <br /> XV <br /> 6 � /YXY <br /> e in e y {Sirgnature Receive by (S�gnature) i 4Noa �o f ^�atelTime -'0.0 <br /> 0A <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Recery I aborat ry , Dat ime <br /> Method of Shipmen P nn Laboratory Name <br /> ©V Q-. I �_ C 6u CJG <br /> Special Iuctwns ` I hereby authorize the performance of the above indicated work <br />