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Advanced CHAIN F CUSTODY RECORD <br /> GeoEnvaonmentalhic. Date Page of <br /> 837 Shaw Road - Stockton, California- 95215 - (209)467 1006 Fax (209) 467 1118 <br /> Cliente'ir'� _ Pro e M nager Tests Required <br /> --� Pone Number <br /> 1..._..1._. , <br /> er <br /> Cie! U 019 / <br /> -- Sam ers Signature) Invoice <br /> ` 1- o' <br /> j <br /> t AG ❑ <br /> P►o)ec,t Name 4(JIT Client <br /> 1. s Q <br /> Sample Location Sample Type Date 1 tme � Water _— Solid No of Notes <br /> Number Descnfatian Comp Greb Air Conts <br /> 21 0-3 <br /> l _ 420 <br /> POVALF 16 2-'5' <br /> 5 <br /> I A <br /> deli uis gnatur aceive y rgnature Trme <br /> 575 �? <br /> Rehnrimshed by (Sign re) Received by (Signalure) atelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) ❑aterl ime <br /> r <br /> Dispatched by (Signature) ❑atelTrme Re i or Laboratory b aterTime <br /> O3 00 <br /> Molhod of Shipment Laboratory MaIrys <br /> i y <br /> Sper ial instructions �r� �r I hereby a tho Ize the pert rmance of the aboOC 17[ve Indicated work <br />