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Advanced CHAIF CUSTODY RECORD <br /> ==_ GeoEnvironmental, Inc. 0,�/D�q Date % Page _ of <br /> 837 Shaw Road Stockton California 95215 - (209)467-1006 - Fax (209) 467-1118 <br /> Prie� ana erClient <br /> Tests Required <br /> P tie N mber <br /> MG7 <br /> Sampl (Sig tune) invoice <br /> Project Namei �+ AGE <br /> l 1�,�' 0 E/t ] / Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grob <br /> Lo-ot. -03 <br /> Ic vt°___ <br /> H AD <br /> CE <br /> ABS <br /> D CNI.o3t1NATEDOf'— �1rPiH <br /> LAA— <br /> PIRSERVATION ,ate MBIAIdR <br /> nelinqu s y atu ece ve y gnature aterrime <br /> I v11 70& <br /> Relingvis ed by (&gnature) V Received by (Stgnature) Datelrime <br /> Relinquishe by (Signature) Received by Mobile Laboratory for(field analyst; (Signature) DatatTime <br /> Dispatched by (Signature) Date/Time I aboratory by Date Ime <br /> Method of Shipment a RECD SEALED&INTACT 0 <br /> /�'A�r � bo story ikameh 1'� '� <br /> Special InstructionsU I here y aut orize t erform a of the above indicated work <br /> 'Via e76 t2 <br />