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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road- Stockton. California- 95215 - (209)467-1006 - Fax(209)467-1118 <br /> Client Projeclt,Manager Tests Required <br /> - f I ,,, ('c,-, <br /> Phone Numr- <br /> Samplers: (Signature) J'LL-- Invoice: <br /> Client E <br /> AGE <br /> Project Name <br /> k <br /> Sample Location Date Time Sample rype Solid No. of Notes <br /> Number Description Water I <br /> Comp. Grab. Air Conts. <br /> �--85 1 0,;� i �< 'I A <br /> L <br /> ei us a 9 6 Received by: (signature) 7 Dat*fT[ a <br /> Adtffiquishiod by: (Signature) Received by: (Signature) Date rime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature Date/Time <br /> Dispatched by: (Signature) D*1*17im* Received for L701 D *JTim* <br /> Method of Shipment: Laboratory Marne <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />