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CHAIN PF CUSTODRECORD <br /> { Advanced A�/'� - <br /> -' Date � b� Page of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road -Stockton, California- 95215 - (209)467-1006- Fax(209)467-1118 D G _ O U <br /> Client p Cj 1' �(� Project Manager <br /> Tests Required <br /> 9/41- ZR72.e- <br /> Phone Number <br /> NuAte <br /> Samplers (Signature) Invoice <br /> Project Nameta4 4*k-z' — AGE <br /> - b Client ❑ <br /> Sample Location Sample Type No of <br /> Date Time Water Solid Notes <br /> Number Description Comp crab Air Conts <br /> &-rbgT--"- 2-fO.2.4 05 <br /> Relinquish y �gr�ture ece ve y Snature r Date/Time <br /> Relinquished by (Signature) Received by (Signature) [ ` Date/Tlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> I <br /> Dispatched by (Signature) Date/Time Received for LaboDate/Time <br /> �-I�✓ 2 - z � s 7n� <br /> Method of Shipment Laboratory Name r <br /> C/ D <br /> Special Inattuctions I hereby aulholize the performance of thea a Indicated work <br /> V � <br />