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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 1-24' x~Page of 2. <br /> of Nonhenf California <br /> 1803 West March Lane,Suite A-Stockton,California-95207-(209)956.0264-Fax(209)956-0700 <br /> Client NaY7 yyiahjj '* S.tj n,S5 Project Manager <br /> 14-4til yt R C It J tf[ t N Tests Requited <br /> Phone Number <br /> {X09 ) `146'0-164 <br /> Samplers (Signature)) Invoice <br /> Project Name C.�uS� (,k-ivroltT--V4st Bgveh �` �` 't � AGE f� <br /> o-h Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No of �'� Notes <br /> Comp Grab Air Conts <br /> t <br /> P20 -;L0 x }( 54—bas, i <br /> 010 -�.+� R �y 1 54686 <br /> x x 54 6 <br /> 4_1 q0' t <br /> Relinqu7s e <br /> kLt- - y ( 19nalure) t <br /> ecewe i et re Date7Time <br /> Relinq <br /> db i ature) 7 :��'4 5-/)0'.10 <br /> R c (Signature <br /> 10��ttefTiirne <br /> Rnquishe by (Signature) Xae v by Mobile Labo tory for field analysis (Signature) ime <br /> Dispatched by (Signature) Dale/Time Received for Laboratory by <br /> DalefTlme <br /> Method of Shipment Laboratory Name <br /> [Special Instructions M `��Ibt <br /> I�f�ESI`AVAT�IE_ _j Ifi'4 'I I hereby authorize the performance of the above Indicated work <br />