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� � � � � ry � i� i• i• � i• � i• <br /> Advanced CHAIN OF CUSTODY RECORD <br /> --- ;'� GeoEnyir onmental, Inc. <br /> Date fo-25-civ page 3 of 3 <br /> 4005 North Wilson Way-Stockton,Califomta 95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> �,� _ Tests Reg <br /> l�r n ot L i rRequiredPhone Number SI <br /> `Ito 7- /o0 il� f <br /> Samplers (Signature) Invoice <br /> Project Name AGE <br /> ► , <br /> A. ar — 5 Client ❑ <br /> -� J � <br /> Sample Location Date Time Water Sampl ype Solid No of D Notes <br /> r <br /> Number Description comp lAir Conts <br /> VW 1 /iaaWov VU I f0 A'-00 I I, S— y X X I A 51417 t <br /> e inqu s e LE� <br /> elReceivedy (Signature) Date[Time <br /> Reit��d by (Signature) Received by (Signature) Dateffime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Datef ime <br /> Dispatched by (Signature) DatefTime Received For Laboratory by Datemme <br /> ,z� 1�-zst 117.27 <br /> Method or Shipment Laboratory Name <br /> Special%nv%xU-Ions I hereby authorize the neriormance of the above indicated work <br /> VIP— <br /> ;yr <br /> TF.��iLjulli.Le «}til'}1-, - �'�id}i31��i.Si4F_��,.., <br />