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taw ttttttttt� �a ii � � � � � � i• i• I• � <br /> . i • i <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> --- ,"_ GeoEnvironmentai, Inc. Date 7, 0 Page ofA-- <br /> 4005 North Wilson Way-Stockton,Calliornla-95205-(209)467-1006-Fax(209)467-1118 n <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> �-01 - qt, 7 -W <br /> z <br /> Samplers- (Signatute)p Invoice, <br /> Project Name New"( 1-4 ltA pod 4 1I Ali i,cf�t� .(, �L AGE OR <br /> �, z-� Client ❑ <br /> Sample Location ample Type No. of ' ti <br /> Number Description Date Time WCater Air Conts Solid � Notes <br /> Cam <br /> Vim' 7 - 3 -= <br /> ` 32583 <br /> y <br /> 32584 <br /> 32585 <br /> 32585 <br /> -3 -1 -0r) q;471 X xx 32587 <br /> s >'V 10-0 `6 X J. <br /> 32588 <br /> 5vvi —30 17,-03 —J <br /> el nqu s e y <br /> ig ata .19 (Signature) <br /> DaterTl ms <br /> 43 �0 r�A t -7-01D I <br /> e]nquished by (Signature) Aecelved by (Signature) Date/Time <br /> tae inqu shed by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/time 77i3l—or Laboratory by Date/Time <br /> Method of Shipment <br /> Laboratory flame <br /> WWI" `�+ f11aow6tr � � � G <br /> 8pectst tnsuuctkons I�W" p�teQ+'�rl{}tt i hereby authorize the performance of the above Indicated work <br /> GOOD cftffl <br /> 1 frilC CC�I11V 11ViY 41",k.t <br />