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t Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc aXa B s Date Page —/— of <br /> 4005 North Wilson Way-Stockton,Callfornia-95205-(209)467-1046-Fax(209)467-1118 <br /> Client Pro ct Ma ger <br /> a Tests Required <br /> P one Number <br /> LIE <br /> a rs (Signature) Invoice <br /> �J Pn AGE <br /> Protect Name�/ /' 4 <br /> Client ❑ <br /> Sample Location Sample TypeDate Time Water Solid No of <br /> Number Description Comp Grab Air Conts ;� 492.89. +_ 1 <br /> I i <br /> ` 49 2�Q_'-__ — <br /> i ., <br /> rr , <br /> 49291 ' - <br /> -4--Ai-2 92 AL4 <br /> '--, <br /> 49294 -�- <br /> � 249295 <br /> ' <br /> e s e y (Signature stews y gna ure 0 e/Time <br /> elmquished by (Sign lute) eived by (Signature) at.'n <br /> l!�9ijIVY <br /> Rehnq y nature) Mr�C'^f;'il��) Rec ived by Mobile Laboratory for field analysis (Signature) OatelTime <br /> _ EJ)DilUcJ`1il <br /> Dispat� P�k�s��(�gn�,hJr�1�-� �41Vf,�iNC�SpatelTime Received for laboratory by Date/TimennVV��ftii�aJJ ii t to <br /> Method of Ship ' - -80 oratory a <br /> Special instfuctio L67 1 hereby uthonz tV p formance of the above indicated work <br /> f . <br />