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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvzronmental, Inc �,� �� � � Date os � � Page � tf_-� <br /> a c1 C_ <br /> 4005 North Wilson Way-Stockton,Catlfomia 95205-(208)467-1006-Fax(20 467-1118 <br /> Client L /n ew 6 L <�'46 6-t- Project Manager Tests Required <br /> Phone Number <br /> Z07 7 4& �t- <br /> Sample (Signature) Invoice <br /> AGE K71 <br /> Project Name Client <br /> Sample Location Sample Type No of -r <br /> Number Description date Time water Solid I _ 67231 <br /> Comp (arab AIT COntS <br /> r6s/1a/ai s�a a� / x 6723 - — <br /> I <br /> AXU3 ' s oat / `a� _'y 3 XLAr�_ fi723�4 <br /> _67235 --- <br /> � <br /> I ' <br /> /►�w 3.Di <br /> 13 7236 _ �— <br /> t <br /> r 7Uv s ),0al 67237 i <br /> I i <br /> 08 <br /> �e inquis a y ignature) ecerve y rgnalure pate(Fime <br /> Relinquish Signature) Received by (Signature) date rime <br /> ft �Relinquished by (Signature) ec ed by Mobile Laboratoryfor Ne 'n I (�'gna re) � Date/Time <br /> Dispatched by (Signature) ate/Ti Re ived for Laboratory by,r Clate(Time <br /> Method of Shipment orato <br /> Spsciaf Instructions 1 hereby autho a the performance of the above indicated work <br />