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...�.. .� .�� t, tttil■f i•� �■� i• tl• l• M I I M IMI <br /> i <br /> ( Advanced CHAIN OF CUSTOD RECORD <br /> GeoEnvironmental, Inc. Date--1--1V-Cf Paye of <br /> 837 Shaw Road-Stockton,California-95215 -(209)467-1006- Fax (209)467-1118 _ <br /> Client i .. Project Manage <br /> Tests Required <br /> Phone Number <br /> i✓ <br /> Samplers (Signature) �✓ Invoice, <br /> Project Name ;44 <br /> , for <br /> / VIJ Ifille, <br /> 1 AGE 0' <br /> tlw-k Client E] <br /> Type <br /> Sample Location Sam ple <br /> Number Description Date rime Water Air Solid Corns No at �4 Notes <br /> Comp (arab Y <br /> Oat <br /> 3 P <br /> � CL <br /> 1 I ZZ5 <br /> Relin ur e_ y ( rgna a eceive y rgnature Date Time <br /> Relinquished by (Signature) Received by (Signature) Date[Time <br /> Relinquished b Si nature <br /> q Y ( li ) Received by Mobile laboratory for field analysis (Signalura) DstelTime <br /> Dispatched by (Signature) Date/Time Received for laboratory by Date/Time <br /> Method of Shipnt ��� labor al L( <br /> VV f VLH <br /> Special instructions I hereby authorize the performance of the above indicated work <br />