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�. .�� �. ...■. 1111111 � is ta• � t, � � � Ir i• � <br /> • i <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page 4— Of <br /> 837 Shaw Road-Siockton, California-95215-(209)467-1006- Fax(209)467-1118 S4L _x J <br /> a= <br /> Client Project Manager c✓� <br /> CVQ')//qX Tests Required <br /> Phone Number <br /> za91 �Ln 7-IQQ <br /> Samplers- (Signature) Invoice <br /> Project NameCt;L f—v i AGS <br /> Client/tr <br /> SampleLocation Sample Type <br /> No of <br /> Number Description Date Time Water Air Solid Coots �� Q? Notes <br /> Comp Grab <br /> �' �� ARE sv� c,a+nc,�a��r�� rtiAlt..� 3 x <br /> �� ► S � ��nr ��y� / �, •'; Boli, <br /> e inis e y igna y re eve y gnature <br /> �o` ce Date/Time <br /> , <br /> (Signature--)- <br /> Relinquished by (Signature) �T�9Nr✓9R�1 <br /> Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Date/Time Roee f Labor by, ate/T e <br /> Meth d of Shipment La ora ry ame - �� <br /> lel l De 41 r.r { <br /> Special instructions I hereby authorize the performance of the above indicated work <br /> �1 <br />