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( Advanced CHAIN OF CUSTODY RECORD <br /> .00 GeoEnvironmental, Inc. Date � ( Page 2- of <br /> 837 Shaw Road - Stockton, California-95215-(209)467-1006- Fax (249)467-1118 <br /> Cllent e Project Manager <br /> i Tests Required <br /> P ne umber 1 <br /> X67--1006 <br /> Samplers (Signature) Invoice <br /> Project Name AGE Xr <br /> yi�wa Client In <br /> r� <br /> Sample Location Sample Type Date Time Water Solid of <br /> Number Description � � Nates <br /> Comp Grab Air Conts <br /> �[ o tsnL/ <br /> A\^)�d ILkzz X X <br /> Relihquished by, (S'i ature) ecetve y ignature <br /> o lamM 30 <br /> Relinquished by (Signature) Received by (Signature) Date Mme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) Date/Time Received for aboratory by D te(T <br /> CGSime <br /> ,l l �f�L'Jl.&. � /0 z <br /> Method of Shipment Laboratory Name <br /> i <br /> Special Instructions V- y� f� i hereby authortz the performance of the abov indicated work <br /> IG <br /> I <br />