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Advanced CHAIN OF CUSTODY RECORD <br /> -__- GeoEnvironmental, Inc. Date 6-7q-0q- Page <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 % – 6 <br /> Client �pQ Protect Manager Fi Sine-C Tests Required <br /> Phone Num r <br /> cxq) <br /> Samplers (Signature) �' f a- Invoice <br /> AGE K <br /> Project Name �a aha �r�SE �`` A, Client ❑ <br /> Sample Location Sample Type Solid No of 1i Notes <br /> Number Description Date Time Water Air Conts <br /> Comp Grab <br /> I I zg <br /> -4-p q A4w -3 M3 <br /> mw •ql�-&pq loq ' <br /> Relinquished y ignature) KeCelviiiCl Dy ignature DatelTtme <br /> i � Ll Pq <br /> ` <br /> Reli uished by (Signature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) ST <br /> pr-1 <br /> 1 Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by /-} Date/Time <br /> Labor ryame <br /> Method of Shipment <br /> {:� ��C-��rC� r C Teal <br /> I hereby authonre the performance of the above Indicated work <br /> Special Instructions <br />