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Advanced <br /> CHAIN <br /> OF CUSTOD RECORD <br /> GeoEnvimnmental, Inc. Date Page of-:?� <br /> 837 Shaw Road- Stockton, California-95215 - (209) 467-1006- Fax (209)467-1118 <br /> Client Project Manager <br /> /L - f�� Tests Required <br /> Phone Number <br /> Lo <br /> Samplers (Signature) Invoice <br /> Project Name AG�, <br /> rI .A - Client ❑ <br /> Sample Loc Ion Satp e Type <br /> Number Description Date Time Water Air Solid No of Conts Notes <br /> Comp Grab <br /> / z .3 -'lir✓ <br /> ��.c�1A �c?�-- � � --1 ill✓✓ <br /> e inqura ign tore) Received y (signature) Date/Tim <br /> Relin y (Sig Received by (Signature) Dat /Time Ct�a1 <br /> Relinquished by (Signature) Received by Mobile laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/rlme Receiv Voixorat by Date/Time <br /> Method of Shipment //7 abaratory kinme <br /> �-el±z 2gfz:��� ( <br /> Speclal InStFuctlOns I hereby autho the performance of ahs above Indicated work <br />