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• <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. 2(00 5 Date '� r, ! Page 1 of �- <br /> 4005 North Wilson Way-Stockton,California-95205 (209)467-1006-Fax(2fl9)467-1118 <br /> Client 00�i V Proje anage <br />� -.r Tests Required <br /> Phone Number <br /> :5u, vl�'- <br /> S s Signature) Invoice <br /> Protect Name C� VW ? AGE <br /> Client ❑ <br /> Sample Location SampieType No of i 68653 <br /> Number Description Date Time Water Air Solid Conts i Js <br /> Comp Grab <br /> ` 68654 <br /> EW 3 og-30 Z 3c, <br /> 68655 <br /> O <br /> W3 /o- d�15� 68656 <br /> r3 (L o=z 3 68657 <br /> 68658 ' y <br /> `l <br /> EJ-3 Q 25 12, 2S_ x 68659 <br /> I i <br /> rz- IZ-' � 3 <br /> rs i ature eceive y ignalure D tefTime <br /> Ra inquta ed by (Signature) Received by (Signature) 6T Datefrime <br /> Relinquished by (Signature) Received by Mobile L bora ory for erd analysis (Signature) Date/Time <br /> UGAS G Ii,ZTUS OVER <br /> Dispatched by (Signature) R ived for Laboratory by Dateffime <br /> GOOD CONDMON APPROPRIATE <br /> Method of Shent C _ Laborator Name <br /> f-b W, f <br /> Special Instruclt na � I her horiz the perform ca of the above indicated work <br /> ��t v s -� ! <br />