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� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnviron mental, Inc o�; C)4-1���% Date�� �q� page L- of �- <br /> 837 Shaw Road- Stockton, California- 95215- (209) 467-1006- Fax (2119) 467-1119 <br /> Client Project Manager Tests Required <br /> Phone Number <br /> tea) Lk67--lvo6 <br /> Samplers (Signature) Invoice- <br /> Project Namew�0- AGE 1K. <br /> Cnase UGa/L ' � 'ellL Client ❑ <br /> .� <br /> sample Location Date Time Sample Type Solid No of Q Notes <br /> Number Description WaterAir Coots <br /> comp arab <br /> I -- <br /> �nw �b t�zgo AVJ k� 31 x x <br /> kW L-74102403 f1/EW V7 ;O 211oT nQk__L k <br /> A&W 2Z to2Ao3 AA V) 22 10)7. a 1033 _ X x <br /> �'\Oj 23 10-zRo3 /W A) 2"� <br /> �w 2N to24o� ,/I/�1�t1 2l� lo��,�t�o3 t�°l�5 �► � <br /> ��y (Signature) ace va y gnalure Data/Trme <br /> to z o iboo <br /> Re 1nq=rlstied by (Signa re) Received by (Signature) Date me <br /> Rellnq,nshed by (Signature) Received by Mobile Laboratory for hold analysis (Signature) ���" Date/Time <br /> Dispatched by (Signature) Date/Tune Recel Laboratory 6y ` J� l� tel�rme <br /> tdethorf of Shipment Labor o Name <br /> C 0Ao Vic' ��1� MG et, <br /> SpeclV_instructions ICIA, I hereby authorize the performance of the above indicated work <br /> F (300 f'[7PJ IOiT_ APPROPRJA <br /> CONI AFTER <br /> DLUILC)RINAIEDINLAIf PRESEJ EDINLAB,,._,_„" <br /> T I'R LSER1rA'I i O13_'6 <br />