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Advanced CHAIN OF CUSTODY RECOR <br /> __ �r <br /> -(- GeovEnvironmental, Inc. Date(I - �2F page ;-;7 of !!! <br /> 837 Shaw Road - Stookton, Callfornla-95216-(209) 467-1006 - Fax (209) 467-1118 <br /> Client 4 LL Pro d Mana C% <br /> f14L C',� &_J Tests Required <br /> Phone Num r <br /> Sam lens; (SIgna urs <br /> ) Invoice: <br /> Project NameAMG140*4 <br /> 11 a( LDN.I i l�ttyw�,� �r �O AGE <br /> t YI c T' Client ❑ <br /> Sample Location Sample Type 4, �a <br /> Number Description Date Time No. of <br /> Water Solid <br /> Comp. Grab. Air Com9. a s <br /> . ,� R ) )¢,�4t t 4 <br /> Ix Y <br /> pp 1 <br /> ,a <br /> r nt 3 , <br /> Jct a r'L.r <br /> 2' Ir x I a14 f In i �a a� i i_1 <br />- <br /> -pig <br /> _ 11 J X r ISLD <br /> eis y: ne urs eoe ve y: gnatura pda m <br /> A 17 A•7` t - - l 53b <br /> Relinquished by: ( ature) Received by: (Signalure) <br /> Da e/Time <br /> Relinquished by: (Signature) Resolved by Mobile Laboratory for 061d analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) - Date/Time Receive for Laborator by- <br /> 10 QbDy%ImoO <br /> Method of SLaboratory Name <br /> hlpmonL' <br /> Special Instructions: tnr�� OAS 0&G P.4ETALS OT!1Efl <br /> C-0- ( i hereby authorize lh y❑ormance Ohs above Indicated work, <br /> NL <br /> PRESERVATION \. .. <br /> t APPROPIiLAIE vlaY �FjenEa{_ <br /> HEAD SPACE All�r:.ir <br /> _�._... SAEI , <br />