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Advanced CHAIN OF CUSTODY RECORD <br /> r <br /> - GeoEnvironmental, Inc Date Page rL of <br /> 837 Shaw Road Stockton California-95215 (209)467 1006- Fax (209) 467-1118 <br /> Client7&r+ <br /> Protect M ger <br /> 7i 1,- Tests Required <br /> onq\Number <br /> _ Sa p ers tgnature) invoice <br /> Protect Nam AGE�,[� <br /> t{' Client E] <br /> Type Typ <br /> Sample Location SampleNo of <br /> Number Description Date Time Water i <br /> Air Solid Conts Notes <br /> Comp Grab <br /> 3 , I <br /> ;115103 141 50 <br /> FRRVVC-Iinqu S•a d b ( i n ura) fldcelv6d by (Signature) U telTi <br /> Relinquished by u ) tie v b S� ureate(Trms <br /> lw y� "s owe <br /> IGEN PRESMA7K ttT <br /> Reiin uiahed b <br /> q i" • -' k Sec ed by Mobile Laboratory for field analysis (Signature) DatelTime <br /> 7A SP'AC 3 r- -,-4r CONTAM1, <br /> DECHW111MAM LN 1.1 _.—RANNOR WAR TAT <br /> Dispatched by (Signature) Date/Time c v for Laboratory by Date/Tlme <br /> 1 <br /> 7 <br /> Method of Shipment r boraMma4L"D <br /> Special Instructions 1 hereby authorize the pet ormance of the above indicated work <br />