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tf! IF w_f7 <br /> 0 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc Date �5` 1� y Page S of 1- <br /> 4005 North Wilson Way Stockton,Catifomla-95205-(209)467-1006-Fax(209)467-1118 <br /> Project Manager <br /> Client �"�!� �� ���� Tests Required <br /> Phone Number <br /> Sampler (Signature) lis' p� Invoice <br /> �� ��iv�' AGE � <br /> f'ro)ect Name . � ��R/ J � Client ❑ <br /> Sample Location Date Time Sample Type Solid No of <br /> Water <br /> r <br /> Number Description comp rAir Conts 67245I <br /> 1 <br /> 67246 <br /> 67247 <br /> elinqu,s y r tura) i Receivedy (Signature) DatelTime <br /> Relinquished by (Signat Received by (Signature) Date(rrme <br /> vowsIDWm sis (s OTHER <br /> Relinquished by (Signature) ecerved b ol��9SERVATIO el ana ysrs (Sr nature) . F Date/Time <br /> GOOD CON) iT(ON p SAT <br /> Dispatched b (Signature) MCAD SPAS PneEi A ![nC Received for Laboratory by Datelrime <br /> p Y � 9 ) v ����I`t I11�)._t,� <br /> Method of Shipment Laboratory NE11fie <br /> Iz- — <br /> Spectral lnStruc%lons i hereby author a the perf mance of the above indicated veork <br />