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i ( Advanced <br /> CHAIN OF CUSTODY RECORD <br /> - GeoEnvironmental, Inc. Date S!(- -c'z Page 2- of Z <br /> 837 Shaw Road - Stockton, California - 95215 (209)467-1006- Fax (249)467-1118 <br /> ClientPro ect Manager <br /> [�S ke tl i`d 1 e tt� C e+� M, � DO _ pts Tests Required <br /> Phone Number T5 <br /> aocii —Li(.0-7 — � <br /> Samplers (Signature) Invoice <br /> Protect Name �w f AGE 8' <br /> C 6"z uc ✓l �V�`e� Client ❑ <br /> Sample Location Sam pe No of } <br /> Number Description ©ate Time Wate Air Solid Cents Notes <br /> LL Comp Grab <br /> C1 1Q K� �s-fG�r1 1411 /1" 3 <br /> �zz�o��fv�L y i&-Ul 16,416 3 <br /> E_�E I <br /> n is a y ( ignatur Weieerve U 5y T 9 1—gn—a 1_u—raT Dateme <br /> Fin., <br /> qu d by (Sig <br /> nature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTims <br /> Dispatched by (Signature) Date/Time Ree iv for Labofafory by me QatelT+ <br /> / S�� Z <br /> Method of Shipment Laboratory Naj6d M C_ rVid kl,—// <br /> ot <br /> SPeclal lnstrunuons +� a . F►i'r I hereby auth ze the performiance of the above indicated work <br /> rl11,TE <br />