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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc ZA Z/-� �c K Date- Page I ofd. <br /> 837 Shaw Road- Stockton,California- 95215 - (209)457-1008 - Fax (208)467-1118 <br /> Client r tStC] WGr1L h u J e Project Manager <br /> Q:%ctn N �Mct Tests Required <br /> Phone Number <br /> a0 - %V7_ <br /> Samplers (Signature) Invoice, <br /> Project Name Fc ,`(�,' AGE S, at l,.� � <br /> Client ❑ <br /> Sample Location Sampl pe aV <br /> Number Date Time No of • <br /> Description Water Solid Z' � Nates <br /> I' <br /> / Comp tush Air CCornts �= <br /> lW y U 11l tl0604 �b � � � It � X <br /> ,I�tr,/l«�r�f <br /> 83022 <br /> 83023 <br /> I1 <br /> i Lo °j 111 ra�� Ll83424 <br /> 83025 <br /> e y (Signature ece ve y gnature <br /> Cateffirne <br /> R gwshed y-(Signature)� l�drp0) I UV <br /> Received by (Signature) E1atalTlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> f)atelTime <br /> Dispatchad by (Signature} DatitTlme Received for C Q A?,ar Laboratory by <br /> Y.n1}ate/i l me <br /> Method of Shipment <br /> CkLaboratory Name Mr-0�� i " WT � <br /> Special Instructions YAS �grrrhl` OT I hereby authorize the perlormance of the above Indicated work <br /> 2t7cc a lrCA� r1J CxU rinL <br /> uL 1 <br /> GOOD CONPITPO�I APPr,'0i_If1ATL <br /> HEAD SPACE ABS►N f CO+iTAINER <br /> I <br />