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CHAIN OF CUSTODGECORD <br /> Advanced Date blil �K— Page <br /> --- GeoEnvixonmental, Inc. <br /> l J 837 Shaw Road-Stockton California-95215-(209)487-1008- Fax (209)467-1118 f <br /> i <br /> Client �--�-� Protm Manager Tests Requimd <br /> 1 P ne Nu be �G <br /> 4ca- tacCe., <br /> Samplers (Slgnatur IrrVolce <br /> - rQ AGE 6� <br /> Project Name � + Client ❑ <br /> Sample Type No of <br /> Sample Location Date me Water Solid Names <br /> Ti <br /> CoritS <br /> Number Description Comp crab Air <br /> -2 <br /> Z 7JUI 4S 4W I (g I I[Gr 12o�) ' <br /> 32C/)Q>c x <br /> JK x I <br /> r(0 <br /> Date kine <br /> - <br /> e qu y n ur eceive y (Signature) 0 tk+`l30 <br /> Relinquished by a e) Received by (Signature) Datefrime <br /> RehngWshad by (Signature) Received by Mobile Laboratory for field analysis (Signature) �ST A7— Date/Time <br /> Dispatched by [Signature) Date/Time Racekwd for aboratory by F DatelTkme <br /> Labors <br /> Method of Shipment Nara <br /> L � the <br /> I hereby au�harizaparior ante of the above Indicated work <br /> Spectal instructions � <br /> 1 <br />